Inspiratory muscle training did not accelerate weaning from mechanical ventilation but did improve tidal volume and maximal respiratory pressures: a randomised trial

Condessa, Robledo Leal; Brauner, Janete Salles; Saul, Ana Clara Bernardi; Baptista, Marcela; Silva, Ana C.T.; Vieira, Sílvia Regina Rios

doi:10.1016/s1836-9553(13)70162-0

Cited by 70 publications

(85 citation statements)

References 25 publications

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“…This is not in keeping with the report by Plani et al, [11] which showed that physiotherapists' involvement in a weaning and extubation protocol implemented in the management of critically ill trauma patients in an SA ICU setting resulted in a clinically significant reduction in MV time. The use of respiratory muscle trainer devices has been shown to significantly increase maximal inspiratory pressure [12,13] and tidal volume [13] and shorten time to weaning from MV. [12] The majority of respondents reported being involved with extubation of patients and more respondents in the current survey reported involvement with adjustment of mechanical ventilator settings and weaning of patients from MV than reported previously.…”

Section: Resultsmentioning

confidence: 99%

Physiotherapy practice in South African intensive care units

Lottering

Aswegen

2016

S Afr J Crit Care

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Background. Physiotherapists are integral members of the interprofessional team that provides care and rehabilitation for patients in intensive care units (ICUs). Objectives. To describe the current practice of physiotherapists in ICUs, determine if physiotherapists' practice has changed since a previous report and determine if practice is evidence based. Methodology. A questionnaire was content validated and made available electronically and in hard copy. Physiotherapists who work in ICUs in public or private sector hospitals or who are members of the South African Society of Physiotherapy were identified and invited to participate. Results. Survey response rate was 33.9%. Patient assessment techniques performed 'very often' included ICU chart assessment (n=90, 83.3%), chest auscultation (n=94, 81.8%) and cough effort (n=81, 75%). Treatment techniques performed 'very often' included manual chest clearance (n=101, 93.5%), in-bed mobilisation and positioning (n=91, 84.3%; n=91, 84.3%, respectively), airway suctioning (n=89, 82.4%), out-of-bed mobilisation (n=84, 77.8%), deep breathing exercises (n=83, 76.9%) and peripheral muscle-strengthening exercises (n=72, 73.1%). More respondents used intermittent positive pressure breathing (57 v. 28%, p=0.00), used adjustment of mechanical ventilation (MV) settings (30 v. 15%, p=0.01), were involved with weaning patients from MV (42 v. 19%, p=0.00) and used incentive spirometry (76 v. 46%, p=0.00) than reported previously. More respondents performed suctioning (99 v. 70%, p=0.00), extubation (60 v. 25%, p=0.00) and adjustment of MV settings (30 v. 12%, p=0.02) than reported internationally. Conclusion. Physiotherapy practice in ICUs is evidence based. Care focuses largely on mobilisation, exercise therapy and multimodality respiratory therapy.

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Section: Resultsmentioning

confidence: 99%

Physiotherapy practice in South African intensive care units

Lottering

Aswegen

2016

S Afr J Crit Care

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“…In PSV ventilation mode or test tube -T, both choices are equally effective and safe to the patient. (12,13) At the end, were collected the realization time of the patient, success or failure information during the procedure, reintubation within 48 hours and its causes. It was also evaluated the need for non-invasive ventilation post extubation, use of vasoactive drugs, if the patient was on hemodialysis or peritoneal dialysis and the SAPS (Simplified Acute Physiology Score) severity scores, which the higher is the score the worst is considered the patient's health status (14) and SOFA (Sepsis-related Organ Failure Assesment).…”

Section: Methodsmentioning

confidence: 99%

Success or failure predictive indexes of extubation in renal transplants patients under mechanical ventilation – pilot study

et al. 2020

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Introduction: Currently, chronic kidney disease (CKD) is a major health problem and in the most severe conditions, kidney transplantation is an alternative treatment. However immunosuppression induced these patients to respiratory complications and endotracheal intubation. In order to assist the decision of the best time for weaning and extubation of these patients, there are predictive indexes that should be considered in preliminary assesment. Objective: To check the capacity of predictive indexes for weaning of mechanical ventilation, rapid shallow breathing index (RSBI), oxygenation rate (PaO 2 /FiO 2 ) and maximum inspiratory pressure (MIP) in predicting the success or extubation failure in kidney transplant patients. Methods: This study is a prospective cohort carried out with patients aged over 18, under mechanical ventilation for more than 24 hours. The patients were submitted to the Spontaneous Breathing Test, also the assessment of the Rapid Shallow Breathing Index, oxygenation index (PaO 2 /FiO 2 ), and maximum inspiratory pressure (MIP) and they were observed during 48 hours after to evaluate the success and extubation failure. Results: A total of 106 patients were eligible, and 20 of these were included with mean age of 46.9 ± 3.06 years and 14 of the subjects were male. Three patients showed extubation failure, and needed to have reintubation within the period of 48 hours as considered. Conclusion: The indices to predict weaning of mechanical ventilation, when within the expected normal values, seem to be able to predict extubation, with the exception of MIP that, even in cases of success, showed itself to be at levels lower than the predicted percentage.

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“…17,22,23 Cader and coworkers 22 randomized 41 patients of 70 years or older into a group receiving IMST (n ϭ 21) or a control group (n ϭ 20). Duration of mechanical ventilation prior to IMST was 7 days.…”

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confidence: 99%

“…• In both the Cader et al 22 and the Condessa et al 23 studies, the patients were intubated, and the need for tracheostomy was considered failed IMST, while in the Martin et al study all the patients had tracheostomy. 17 • The duration of mechanical ventilation prior to IMST ranged between 7 and 42 days.…”

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confidence: 99%

What Are the Implications of Blunted Load Compensation Responses in Prolonged-Weaning Patients?

Sassoon

2013

Respir Care

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Inspiratory muscle training did not accelerate weaning from mechanical ventilation but did improve tidal volume and maximal respiratory pressures: a randomised trial

Abstract: Inspiratory muscle training did not shorten the weaning period significantly but it increased respiratory muscle strength and tidal volume.

Cited by 70 publications

References 25 publications

Physiotherapy practice in South African intensive care units

Physiotherapy practice in South African intensive care units

Success or failure predictive indexes of extubation in renal transplants patients under mechanical ventilation – pilot study

What Are the Implications of Blunted Load Compensation Responses in Prolonged-Weaning Patients?

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