TY - JOUR
T1 - Feasibility, safety, and patient acceptability of electronic inspiratory muscle training in patients who require prolonged mechanical ventilation in the intensive care unit
T2 - a dual-centre observational study
AU - Nickels, Marc
AU - Erwin, Katie
AU - McMurray, Grant
AU - Talbot, Richie
AU - Strong, Mark
AU - Krishnan, Anand
AU - van Haren, Frank M P
AU - Bissett, Bernie
N1 - Funding Information:
We gratefully acknowledge the Jill Nosworthy grant from the Australian Physiotherapy Association for supporting this study and the Queensland Cardiorespiratory Physiotherapy Network. Neither funding body had any influence over study design, analysis, or manuscript development at any stage.
Funding Information:
We gratefully acknowledge the Jill Nosworthy grant from the Australian Physiotherapy Association for supporting this study and the Queensland Cardiorespiratory Physiotherapy Network. Neither funding body had any influence over study design, analysis, or manuscript development at any stage.The authors gratefully acknowledge the support of the physiotherapists of the Physiotherapy Department at Canberra and Princess Alexandra Hospitals who provided the intervention and Dr Terry Neeman from the Australian National University for her kind assistance with the statistical analysis. The authors thank the patients for agreeing to participate in this study.
Publisher Copyright:
© 2023 Australian College of Critical Care Nurses Ltd
PY - 2023/6/14
Y1 - 2023/6/14
N2 - BACKGROUND: Inspiratory muscle training (IMT) is an intervention that can be used to rehabilitate the respiratory muscle deconditioning experienced by patients with critical illness, requiring prolonged mechanical ventilation. Clinicians are currently using mechanical threshold IMT devices that have limited resistance ranges.OBJECTIVES: The objective of this study was to evaluate the safety, feasibility, and acceptability of using an electronic device to facilitate IMT with participants requiring prolonged mechanical ventilation.METHOD: A dual-centre observational cohort study, with convenience sampling, was conducted at two tertiary intensive care units. Daily training supervised by intensive care unit physiotherapists was completed with the electronic IMT device. A priori definitions for feasibility, safety, and acceptability were determined. Feasibility was defined as more than 80% of planned sessions completed. Safety was defined as no major adverse events and less than 3% minor adverse event rate, and acceptability was evaluated following the acceptability of intervention framework principles.RESULTS: Forty participants completed 197 electronic IMT treatment sessions. Electronic IMT was feasible, with 81% of planned sessions completed. There were 10% minor adverse events and no major adverse events. All the minor adverse events were transient without clinical consequences. All the participants who recalled completing electronic IMT sessions reported that the training was acceptable. Acceptability was demonstrated; over 85% of participants reported that electronic IMT was either helpful or beneficial and that electronic IMT assisted their recovery.CONCLUSION: Electronic IMT is feasible and acceptable to complete with critically ill participants who require prolonged mechanical ventilation. As all minor adverse events were transient without clinical consequences, electronic IMT can be considered a relatively safe intervention with patients who require prolonged mechanical ventilation.
AB - BACKGROUND: Inspiratory muscle training (IMT) is an intervention that can be used to rehabilitate the respiratory muscle deconditioning experienced by patients with critical illness, requiring prolonged mechanical ventilation. Clinicians are currently using mechanical threshold IMT devices that have limited resistance ranges.OBJECTIVES: The objective of this study was to evaluate the safety, feasibility, and acceptability of using an electronic device to facilitate IMT with participants requiring prolonged mechanical ventilation.METHOD: A dual-centre observational cohort study, with convenience sampling, was conducted at two tertiary intensive care units. Daily training supervised by intensive care unit physiotherapists was completed with the electronic IMT device. A priori definitions for feasibility, safety, and acceptability were determined. Feasibility was defined as more than 80% of planned sessions completed. Safety was defined as no major adverse events and less than 3% minor adverse event rate, and acceptability was evaluated following the acceptability of intervention framework principles.RESULTS: Forty participants completed 197 electronic IMT treatment sessions. Electronic IMT was feasible, with 81% of planned sessions completed. There were 10% minor adverse events and no major adverse events. All the minor adverse events were transient without clinical consequences. All the participants who recalled completing electronic IMT sessions reported that the training was acceptable. Acceptability was demonstrated; over 85% of participants reported that electronic IMT was either helpful or beneficial and that electronic IMT assisted their recovery.CONCLUSION: Electronic IMT is feasible and acceptable to complete with critically ill participants who require prolonged mechanical ventilation. As all minor adverse events were transient without clinical consequences, electronic IMT can be considered a relatively safe intervention with patients who require prolonged mechanical ventilation.
KW - Breathing exercises
KW - Critical care
KW - Intensive care
KW - Mechanical ventilation
KW - Physiotherapy (techniques)
UR - http://www.scopus.com/inward/record.url?scp=85161816071&partnerID=8YFLogxK
U2 - 10.1016/j.aucc.2023.04.008
DO - 10.1016/j.aucc.2023.04.008
M3 - Article
C2 - 37321882
SN - 1036-7314
SP - 1
EP - 7
JO - Australian Critical Care
JF - Australian Critical Care
ER -