The role of inspiratory muscle training in difficult weaning

Postgraduate Thesis uoadl:2875422 49 Read counter

Unit:
Κατεύθυνση Καρδιοπνευμονική Αποκατάσταση και Αποκατάσταση Πασχόντων ΜΕΘ
Library of the School of Health Sciences
Deposit date:
2019-06-02
Year:
2019
Author:
Karagkouni Afentia
Supervisors info:
Ζακυνθινός Σπυρίδων, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Μεντζελόπουλος Σπυρίδων, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Καλομενίδης Ιωάννης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Ο ρόλος της εκγύμνασης των εισπνευστικών μυών στη δύσκολη αποδέσμευση από τον αναπνευστήρα στη ΜΕΘ
Languages:
English
Translated title:
The role of inspiratory muscle training in difficult weaning
Summary:
Background
Inspiratory muscle weakness is a result of mechanical ventilation that constitutes a risk factor for weaning failure in critically ill patients. Research that investigates the use of inspiratory muscle training (IMT) in ventilatory dependent, difficult to be weaned patients, has suggested that this training strategy is associated with successful weaning from mechanical ventilation (MV).
Methods
A literature search was conducted in the following databases: PubMed, Scopus and Google scholar. The keywords used were the following inspiratory muscle training, mechanical ventilation, intensive care unit, critical illness, weaning/failure, ventilatory induced diaphragm dysfunction. In the review we included randomized control trials of rehabilitation interventions intended to strengthen the respiratory muscles in critically ill adults.
Results
In this review 11 randomized control trials are included involving critically ill patients. The studies used different devices of training and training protocols. Inspiratory muscle training significantly improved maximal inspiratory pressure and weaning success in comparison with sham or no training group. Additionally, weaning duration decreased, among patients with weaning difficulties. Considering, length of stay or survival either weren’t significantly affected or weren’t measured.
Conclusions
On the condition that diaphragm dysfunction is identified as a reason for weaning failure, a good approach is to improve respiratory muscle function. Inspiratory muscle training contributes to significant improvement of inspiratory muscle strength and leads to successful weaning from MV. Further larger randomized studies are needed to determine the impact of IMT on clinical outcomes, such as duration of mechanical ventilation, successful extubation, ICU-length of stay or survival.
Main subject category:
Health Sciences
Keywords:
Inspiratory muscle training, Mechanical ventilation, Intensive Care Unit, Critically ill patient, Weaning, Ventilator induced diaphragm dysfunction
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
84
Number of pages:
53

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