JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL

Inspiratory muscle training improves maximal inspiratory pressure and may assist weaning in older intubated patients: a randomised trial

Samária Ali Cader, Rodrigo Gomes de Souza Vale, Juracy Correa Castro, Silvia Corrêa Bacelar, Cintia Biehl, Maria Celeste Vega Gomes, Walter Eduardo Cabrer, Estélio Henrique Martin Dantas
Journal of Physiotherapy 2010, 56 (3): 171-7
20795923

QUESTIONS: Does inspiratory muscle training improve maximal inspiratory pressure in intubated older people? Does it improve breathing pattern and time to wean from mechanical ventilation?

DESIGN: Randomised trial with concealed allocation and intention-to-treat analysis.

PARTICIPANTS: 41 elderly, intubated adults who had been mechanically ventilated for at least 48 hr in an intensive care unit.

INTERVENTION: The experimental group received usual care plus inspiratory muscle training using a threshold device, with an initial load of 30% of their maximal inspiratory pressure, increased by 10% (absolute) daily. Training was administered for 5 min, twice a day, 7 days a week from the commencement of weaning until extubation. The control group received usual care only.

OUTCOME MEASURES: The primary outcome was the change in maximal inspiratory pressure during the weaning period. Secondary outcomes were the weaning time (ie, from commencement of pressure support ventilation to successful extubation), and the index of Tobin (ie, respiratory rate divided by tidal volume during a 1-min spontaneous breathing trial).

RESULTS: Maximal inspiratory pressure increased significantly more in the experimental group than in the control group (MD 7.6 cmH(2)0, 95% CI 5.8 to 9.4). The index of Tobin decreased significantly more in the experimental group than in the control group (MD 8.3 br/min/L, 95% CI 2.9 to 13.7). In those who did not die or receive a tracheostomy, time to weaning was significantly shorter in the experimental group than in the control group (MD 1.7 days, 95% CI 0.4 to 3.0).

CONCLUSIONS: In intubated older people, inspiratory muscle training improves maximal inspiratory pressure and the index of Tobin, with a reduced weaning time in some patients.

TRIAL REGISTRATION: NCT00922493.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
20795923
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"