Effect of high- and low-intensity inspiratory muscle training on weaning outcomes in patients with weaning difficulties: RCT, IMweanT study

<bold>Introduction</bold> Inspiratory muscle training (IMT) improves respiratory muscle function in patients with weaning difficulties. Whether IMT improves clinical outcomes and respiratory function is undetermined. <bold>Aim</bold> Assessing effects of high-intensity IMT (H-IMT) vs. sham low-intensity IMT (L-IMT) on clinical outcomes and respiratory function in patients with weaning difficulties. <bold>Methods</bold> Patients performed daily IMT sessions (4sets, 6–10 breaths) until weaning success or for 28 days. H- IMT group (n=43, 27%male, age:57±15y) trained at the highest tolerable external load (30-50% maximal inspiratory pressure, PImax) and sham L-IMT group (n=45, 24%male, age:60±12y) at max. 10%PImax. Differences in clinical outcomes and respiratory function were recorded. <bold>Results</bold> Both groups had similar weaning success rates and weaning duration (Table 1). Both improved PImax and vital capacity significantly, with H-IMT yielding greater vital capacity gains. H-IMT improved peak inspiratory flow and rapid shallow breathing index, yet not significantly different from sham L-IMT. <bold>Conclusions</bold> Both IMT protocols have similar favourable weaning outcomes, consistent with prior studies on IMT. While both improved respiratory muscle function, H-IMT had greater impact on pulmonary function. More research is needed to optimise the IMT protocol and assess the impact of the internal load on the inspiratory muscles. <fig><object-id>erj;64/suppl_68/PA4127/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>