Specific inspiratory muscle training is safe in selected patients who are ventilator-dependent: a case series

Bissett, Bernie, Leditschke. I.Anne and Green, Margot (2012) Specific inspiratory muscle training is safe in selected patients who are ventilator-dependent: a case series. Intensive and Critical Care Nursing, 28 2: 98-104. doi:10.1016/j.iccn.2012.01.003


Author Bissett, Bernie
Leditschke. I.Anne
Green, Margot
Title Specific inspiratory muscle training is safe in selected patients who are ventilator-dependent: a case series
Journal name Intensive and Critical Care Nursing   Check publisher's open access policy
ISSN 0964-3397
1532-4036
Publication date 2012-04
Sub-type Article (original research)
DOI 10.1016/j.iccn.2012.01.003
Open Access Status
Volume 28
Issue 2
Start page 98
End page 104
Total pages 7
Place of publication London, United Kingdom
Publisher Churchill Livingstone
Subject 2906 Critical Care
Formatted abstract
Background: Mechanical ventilation of intensive care patients results in inspiratory muscle weakness. Inspiratory muscle training may be useful, but no studies have specifically described the physiological response to training.

Research questions: Is inspiratory muscle training with a threshold device safe in selected ventilator-dependent patients? Does inspiratory muscle strength increase with high-intensity inspiratory muscle training in ventilator-dependent patients?

Design:
Prospective cohort study of 10 medically stable ventilator-dependent adult patients.

Setting: Tertiary adult intensive care unit.

Methods: Inspiratory muscle training 5-6 days per week with a threshold device attached to the tracheostomy without supplemental oxygen.

Outcome measures: Physiological response to training (heart rate, mean arterial pressure, oxygen saturation and respiratory rate), adverse events, training pressures.

Results: No adverse events were recorded in 195 sessions studied. For each patient's second training session, no significant changes in heart rate (Mean Difference 1.3bpm, 95% CI -2.7 to 5.3), mean arterial pressure (Mean Difference -0.9mmHg, 95% CI -6.4 to 4.6), respiratory rate (Mean Difference 1.2bpm, 95% CI -1.1 to 3.5bpm) or oxygen saturation (Mean Difference 1.2%, 95% CI -0.6 to 3.0) were detected Training pressures increased significantly (Mean Difference 18.6cmH 2O, 95% CI 11.8-25.3).

Conclusion: Threshold-based inspiratory muscle training can be delivered safely in selected ventilator-dependent patients without supplemental oxygen. Inspiratory muscle training is associated with increased muscle strength, which may assist ventilatory weaning. 
Keyword Inspiratory muscle training
Intensive care
Physiotherapy
Safety
Ventilator weaning methods
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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