Τίτλος:
The combination of inspiratory muscle training and high-flow nasal
cannula oxygen therapy for promoting weaning outcomes in
difficult-to-wean patients: protocol for a randomised controlled trial
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: According to the literature, 20-30% of intubated patients
are difficult to wean off mechanical ventilation and have a prolonged
intensive care unit (ICU) stay with detrimental effects on muscle
strength, functional ability and quality of life. Inspiratory muscle
training (IMT) via a threshold device has been proposed as an effective
exercise for minimising the effects of mechanical ventilation on
respiratory muscles of critically ill patients with prolonged weaning.
In addition, high-flow nasal cannula (HFNC) oxygen has been proved to
provide efficient support for both high- and low-risk patients after
extubation, thus preventing re-intubation.
Material and methods: A randomised controlled trial was designed to
assess the efficacy of combining IMT and HFNC as therapeutic strategies
for patients with high risk for weaning failure. Once patients with
prognostic factors of difficult weaning are awake, ventilated with
support settings and cooperative, they will be randomised to one of the
two following study groups: intervention group (IMT and HFNC) and
control group (IMT and Venturi mask). IMT will start as soon as
possible. Each allocated oxygen delivery device will be applied
immediately after extubation. IMT intervention will continue until
patients’ discharge from ICU. The primary outcome is the rate of weaning
failure. Secondary outcomes are maximal inspiratory and expiratory
strength, endurance of respiratory muscles, global muscle strength,
functional ability and quality of life along with duration of
ventilation (days) and ICU and hospital length of stay.
Conclusion: The present study could significantly contribute to
knowledge of how best to treat patients with difficult weaning and high
risk of re-intubation.
Συγγραφείς:
Patsaki, Irini
Christakou, Anna
Papadopoulos, Emmanouel and
Katartzi, Martha
Kouvarakos, Alexandros
Siempos, Ilias and
Tsimouris, Dimitris
Skoura, Anastasia
Xatzimina, Antonina and
Malachias, Sotirios
Koulouris, Nikolaos
Grammatopoulou, Eirini
and Zakinthinos, Spiros
Ischaki, Eleni
Περιοδικό:
ERJ Open Research
Εκδότης:
EUROPEAN RESPIRATORY SOC JOURNALS LTD
DOI:
10.1183/23120541.00088-2020
