Maximal inspiratory and expiratory pressure measurement in tracheotomised patients

Abstract

The present study compared four different sites and conditions for the measurement of maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) in 38 spontaneous breathing tracheotomised patients. Of the patients, 28 had chronic obstructive pulmonary disease (COPD).The four different conditions were: 1) through a cuff inflated cannula (condition A); 2) through the mouth with a deflated cannula (condition B); 3) through the mouth with a phonetic uncuffed cannula (condition C); and 4) through the mouth after stoma closure (condition D). Five trials in each condition were performed using a standardised method.The measurement of both MIP and MEP differed significantly depending on the condition of measurement. MIP taken in condition A was significantly higher when compared with conditions B, C and D. MEP in condition A was significantly higher when compared with condition B and D. In condition A the highest frequency of the best measurement of MIP and MEP was observed at the fourth and fifth effort, respectively. The same results were obtained after the selection of only COPD patients.In conclusion, respiratory muscle assessment differs significantly depending on measurement condition. Measurement through inflated cannula tracheotomy yields higher values of both maximal inspiratory and maximal expiratory pressure.

Inspiratory muscle training in difficult to wean patients: work it harder, make it better, do it faster, makes us stronger

“…Secondly, the measurement of maximal inspiratory pressure is volitional and great attention should therefore be paid to how to perform the maneuver. We suggest to use the procedure proposed by Vitacca and colleagues [12], who studied different methods to record maximal inspiratory pressure in spontaneously breathing patients with tracheotomy, like those enrolled in the study by Martin and colleagues [1]. The IMT proposed in the study implies that the patients were able to achieve spontaneous breathing autonomy and to breathe without supplemental oxygen, largely reducing the application of the protocol [1].…”

Functional Recovery Following Physical Training in Tracheotomized and Chronically Ventilated Patients

“…22,23 We used the 6-point Kendall muscle testing scale to assess peripheral muscle performance of the femoral quadriceps muscles, the latissimus dorsi, and the brachial biceps muscle. 24 We took the Kendall muscle testing measurements on the dominant limb, with the patient in the sitting position.…”

Improvement in the Prediction of Ventilator Weaning Outcomes by an Artificial Neural Network in a Medical ICU

“…The subjects exhibited no acute pulmonary or neuromuscular problems or signs of increased intracranial pressure before the study, and their S pO 2 was Ն95%. In addition, subjects had to meet the following routine measurements of weaning profiles [24][25][26][27] : bed position elevated to 30°, P I max Յ Ϫ18 cm H 2 O, spontaneous breathing frequency Յ 38 breaths/min, and RSBI Յ 110 breaths/min/L. All subjects were mechanically ventilated with a Evita 4 (Dräger, Lübeck, Germany) or Galileo Gold (Hamilton Medical, Reno, Nevada) ventilator in the PSV mode to maintain a V T of ϳ10 mL/kg of ideal body weight.…”