Respiratory Muscle Rehabilitation in Patients with Prolonged Mechanical Ventilation: A Targeted Approach

Abstract

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2020. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2020. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http:// www.springer.com/series/8901.

Physical Medicine and Rehabilitation and Pulmonary Rehabilitation for COVID-19

“…equipment and given the questionable outcome of early mobilization in the ICU, 5 early mobilization by additional rehabilitation staff is not recommended in the ICU and may be a consideration by dedicated ICU staff. 2 Respiratory muscle weakness from diaphragm proteolysis may occur after prolonged mechanical ventilation 18 and inspiratory muscle training may occur during weaning trials with a skilled respiratory therapist. 18,19 Initiation of pulmonary rehabilitation in the inpatient setting should occur with safety criteria in mind.…”

“…2 Respiratory muscle weakness from diaphragm proteolysis may occur after prolonged mechanical ventilation 18 and inspiratory muscle training may occur during weaning trials with a skilled respiratory therapist. 18,19 Initiation of pulmonary rehabilitation in the inpatient setting should occur with safety criteria in mind. Approximately 3% to 5% of otherwise healthy patients can progress within 7 to 14 days of infection to severe or even critical conditions.…”

“…In addition, respiratory muscle weakness from diaphragm proteolysis may be suspected in those patients with prolonged mechanical ventilation. 18 Inspiratory and expiratory muscle training can be implemented in these patients starting with incentive spirometry and progressing to inspiratory muscle training devices if available. 18,19 Copyright © 2020 Wolters Kluwer Health, Inc.…”

“…18 Inspiratory and expiratory muscle training can be implemented in these patients starting with incentive spirometry and progressing to inspiratory muscle training devices if available. 18,19 Copyright © 2020 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.…”

Dispositivos de Treino Muscular Inspiratório em idosos com desmame da ventilação mecânica e com traqueostomia

“…No estudo de 15 anos da inovadora Bissett et al 26 , mostraram que o uso do TMI com dispositivo de carga linear nas UTIs em pacientes com desmame da ventilação mecânica invasiva, apresenta atraso nas evidencias e insucesso nos protocolos utilizados e a carga linear emprega durante o treino, devido a complexidade dos paciente críticos nas UTIs, como instabilidade hemodinâmica, drogas vasoativas e sedativos, porém o sucesso no desmame da ventilação mecânica em alguns protocolos mostram segurança no TMI. Embora o treinamento muscular inspiratório seja efi caz no fortalecimento dos músculos inspiratórios e na aceleração do desmame do ventilador em pacientes de UTI, os pesquisadores mostram que há necessidade de novos estudos e protocolos específi cos.…”