The Impact of Inspiratory Muscle Training on Respiratory Function in Ventilator-Dependent Patients

Background: Acute respiratory failure is a primary reason for the use of mechanical ventilators, with the primary goal of maintaining gas exchange and sustaining life. Once the patient’s condition improves, weaning from the ventilator must begin. However, approximately 40-50% of patients face challenges in successfully weaning from the ventilator. Respiratory muscle weakness or fatigue is a significant factor contributing to weaning failure. Inspiratory muscle training (IMT) is considered an effective treatment method to enhance inspiratory muscle strength and increase the success rate of ventilator weaning. Therefore, this study aims to investigate whether IMT can improve the inspiratory muscle strength and endurance of ICU patients dependent on mechanical ventilation. Methods: This study adopted an interventional experimental design, selecting 60 ICU patients using invasive mechanical ventilation, divided into a training group and a control group, each with 30 patients. The training group underwent a 3-week inspiratory muscle training program, while the control group only received the conventional weaning protocol. Measurements included maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), peak expiratory flow (PEF), rapid shallow breathing index (RSBI), days on mechanical ventilation, and other clinical indicators. Results: The training group showed a significant reduction in days on mechanical ventilation (12.59 ± 5.17 d vs. 18.06 ± 8.82 d, P = .043). The training group also demonstrated greater improvement in creatinine (CR) levels compared to the control group (0.31 ± 0.93 vs. -0.72 ± 0.92, P = .003). Additionally, the training group showed significant improvements in MIP (31.18 ± 6.80 cm H2O vs. 20.31 ± 10.24 cm H2O, P = .002), MEP (28.94 ± 9.29 cm H2O vs. 21.00 ± 10.02 cm H2O, P = .036), PEF (36.00 ± 10.49 vs. 26.50 ± 9.57, P = .008), and RSBI (95.44 ± 42.02 vs. 141.78 ± 71.32, P = .042) compared to the control group. Conclusions: Inspiratory muscle training significantly enhances the inspiratory muscle strength, endurance, and respiratory function of ICU patients dependent on mechanical ventilation. It reduces the duration of mechanical ventilation and improves the success rate of ventilator weaning. Early intervention with IMT is crucial for improving respiratory health and reducing healthcare costs.

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Journal
Respiratory Care
Published
2024-10-01
DOI
https://doi.org/10.4187/respcare.20244138265
Primary Topic
Respiratory Support and Mechanisms
Type
article
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article

The Impact of Inspiratory Muscle Training on Respiratory Function in Ventilator-Dependent Patients

Shu-Yun Hung, Jui-Fang Liu
Respiratory Care
Respiratory Support and Mechanisms
article

The Impact of Inspiratory Muscle Training on Respiratory Function in Ventilator-Dependent Patients

Shu-Yun Hung, Jui-Fang Liu
article en

Abstract

Background: Acute respiratory failure is a primary reason for the use of mechanical ventilators, with the primary goal of maintaining gas exchange and sustaining life. Once the patient’s condition improves, weaning from the ventilator must begin. However, approximately 40-50% of patients face challenges in successfully weaning from the ventilator. Respiratory muscle weakness or fatigue is a significant factor contributing to weaning failure. Inspiratory muscle training (IMT) is considered an effective treatment method to enhance inspiratory muscle strength and increase the success rate of ventilator weaning. Therefore, this study aims to investigate whether IMT can improve the inspiratory muscle strength and endurance of ICU patients dependent on mechanical ventilation. Methods: This study adopted an interventional experimental design, selecting 60 ICU patients using invasive mechanical ventilation, divided into a training group and a control group, each with 30 patients. The training group underwent a 3-week inspiratory muscle training program, while the control group only received the conventional weaning protocol. Measurements included maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), peak expiratory flow (PEF), rapid shallow breathing index (RSBI), days on mechanical ventilation, and other clinical indicators. Results: The training group showed a significant reduction in days on mechanical ventilation (12.59 ± 5.17 d vs. 18.06 ± 8.82 d, P = .043). The training group also demonstrated greater improvement in creatinine (CR) levels compared to the control group (0.31 ± 0.93 vs. -0.72 ± 0.92, P = .003). Additionally, the training group showed significant improvements in MIP (31.18 ± 6.80 cm H2O vs. 20.31 ± 10.24 cm H2O, P = .002), MEP (28.94 ± 9.29 cm H2O vs. 21.00 ± 10.02 cm H2O, P = .036), PEF (36.00 ± 10.49 vs. 26.50 ± 9.57, P = .008), and RSBI (95.44 ± 42.02 vs. 141.78 ± 71.32, P = .042) compared to the control group. Conclusions: Inspiratory muscle training significantly enhances the inspiratory muscle strength, endurance, and respiratory function of ICU patients dependent on mechanical ventilation. It reduces the duration of mechanical ventilation and improves the success rate of ventilator weaning. Early intervention with IMT is crucial for improving respiratory health and reducing healthcare costs.

Respiratory CareVol. 69(10_suppl)
Chang Gung University of Science and Technology (TW), Yuan's General Hospital (TW)
Openalex Percentile: Top 41%
Respiratory Support and Mechanisms
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