Inspiratory Muscle Training in Patients With Prolonged Mechanical Ventilation: Narrative Review

Ahmed, Shakeel; Martin, A. Daniel; Smith, Barbara K.

doi:10.1097/cpt.0000000000000092

Cited by 18 publications

(23 citation statements)

References 56 publications

(71 reference statements)

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“…Mechanical ventilation (MV) is a tool used to restore or improve gas exchange in patients unable to maintain adequate alveolar ventilation. 1,2 Annually, there are hundreds of thousands of people in intensive care units and operating rooms who are submitted to MV, and it is estimated that between 4 and 13% require mechanical ventilation for long periods. 3–5 Indications for mechanical ventilation include respiratory failure secondary to lung disease, neuromuscular disease, and patients undergoing surgery under general anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Sigh maneuver protects healthy lungs during mechanical ventilation in adult Wistar rats

Silva

Matos

Souza

et al. 2020

Exp Biol Med (Maywood)

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Mechanical ventilation (MV) is a tool used for the treatment of patients with acute or chronic respiratory failure. However, MV is a non-physiological resource, and it can cause metabolic disorders such as release of pro-inflammatory cytokines and production of reactive oxygen species. In clinical setting, maneuvers such as sigh, are used to protect the lungs. Thus, this study aimed to evaluate the effects of sigh on oxidative stress and lung inflammation in healthy adult Wistar rats submitted to MV. Male Wistar rats were divided into four groups: control (CG), mechanical ventilation (MVG), MV set at 20 sighs/h (MVG20), and MV set at 40 sighs/h (MVG40). The MVG, MVG20, and MVG40 were submitted to MV for 1 h. After the protocol, all animals were euthanized and the blood, bronchoalveolar lavage fluid, and lungs were collected for subsequent analysis. In the arterial blood, MVG40 presented higher partial pressure of oxygen and lower partial pressure of carbon dioxide compared to control. The levels of bicarbonate in MVG20 were lower compared to CG. The neutrophil influx in bronchoalveolar lavage fluid was higher in the MVG compared to CG and MVG40. In the lung parenchyma, the lipid peroxidation was higher in MVG compared to CG, MVG20, and MVG40. Superoxide dismutase and catalase activity were higher in MVG compared to CG, MVG20, and MVG40. The levels of IL-1, IL-6, and TNF in the lung homogenate were higher in MVG compared to CG, MVG20, and MVG40. The use of sigh plays a protective role as it reduced redox imbalance and pulmonary inflammation caused by MV.

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Section: Introductionmentioning

confidence: 99%

Sigh maneuver protects healthy lungs during mechanical ventilation in adult Wistar rats

Silva

Matos

Souza

et al. 2020

Exp Biol Med (Maywood)

View full text Add to dashboard Cite

show abstract

“…Approximately 40% of patients who are admitted to intensive care unit (ICU) require mechanical ventilation at some stage of their treatment. Those patient who received mechanical ventilation support are at higher risk to develop chest infections, atelectasis, as well as sputum retentions, which make weaning from mechanical ventilation more difficult and result in higher morbidity and mortality rate (10) .…”

Section: Discussionmentioning

confidence: 99%

“…If the patient had accumulation of secretion, technique was applied on affected segment for about 5 minutes. (4) Muscle training for upper and lower limbs: for 10 minutes (10) .…”

Section: The Training To Inspiratory Muscle Was Performed As the Followingmentioning

confidence: 99%

Effect of Modifying Mechanical Ventilator Trigger Sensitivity on Arterial Blood Gases in ICU Patients

Ismail¹,

El-Nahass²,

Abdeen³

et al. 2021

The Egyptian Journal of Hospital Medicine

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“…Mechanical ventilation (MV) is an important therapeutic tool to restore or improve gas exchange in patients with respiratory failure [1][2][3]. Many subjects in intensive care units and operating rooms undergo MV every year.…”

Section: Introductionmentioning

confidence: 99%

Different Tidal Volumes May Jeopardize Pulmonary Redox and Inflammatory Status in Healthy Rats Undergoing Mechanical Ventilation

Cândido

Matos

Castro

et al. 2021

Oxidative Medicine and Cellular Longevity

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Mechanical ventilation (MV) is essential for the treatment of critical patients since it may provide a desired gas exchange. However, MV itself can trigger ventilator-associated lung injury in patients. We hypothesized that the mechanisms of lung injury through redox imbalance might also be associated with pulmonary inflammatory status, which has not been so far described. We tested it by delivering different tidal volumes to normal lungs undergoing MV. Healthy Wistar rats were divided into spontaneously breathing animals (control group, CG), and rats were submitted to MV (controlled ventilation mode) with tidal volumes of 4 mL/kg (MVG4), 8 mL/kg (MVG8), or 12 mL/kg (MVG12), zero end-expiratory pressure (ZEEP), and normoxia ( Fi O 2 = 21 % ) for 1 hour. After ventilation and euthanasia, arterial blood, bronchoalveolar lavage fluid (BALF), and lungs were collected for subsequent analysis. MVG12 presented lower PaCO2 and bicarbonate content in the arterial blood than CG, MVG4, and MVG8. Neutrophil influx in BALF and MPO activity in lung tissue homogenate were significantly higher in MVG12 than in CG. The levels of CCL5, TNF-α, IL-1, and IL-6 in lung tissue homogenate were higher in MVG12 than in CG and MVG4. In the lung parenchyma, the lipid peroxidation was more important in MVG12 than in CG, MVG4, and MVG8, while there was more protein oxidation in MVG12 than in CG and MVG4. The stereological analysis confirmed the histological pulmonary changes in MVG12. The association of controlled mode ventilation and high tidal volume, without PEEP and normoxia, impaired pulmonary histoarchitecture and triggered redox imbalance and lung inflammation in healthy adult rats.

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Inspiratory Muscle Training in Patients With Prolonged Mechanical Ventilation: Narrative Review

Cited by 18 publications

References 56 publications

Sigh maneuver protects healthy lungs during mechanical ventilation in adult Wistar rats

Sigh maneuver protects healthy lungs during mechanical ventilation in adult Wistar rats

Effect of Modifying Mechanical Ventilator Trigger Sensitivity on Arterial Blood Gases in ICU Patients

Different Tidal Volumes May Jeopardize Pulmonary Redox and Inflammatory Status in Healthy Rats Undergoing Mechanical Ventilation

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