TY - JOUR
T1 - Inspiratory muscle training to enhance recovery from mechanical ventilation: A randomised trial
AU - BISSETT, Bernie
AU - Leditschke, Isabel Anne
AU - Neeman, Teresa
AU - Boots, Robert
AU - Paratz, Jennifer
PY - 2016
Y1 - 2016
N2 - Background In patients who have been mechanically ventilated, inspiratory muscles remain weak and fatigable following ventilatory weaning, which may contribute to dyspnoea and limited functional recovery. Inspiratory muscle training may improve inspiratory muscle strength and endurance following weaning, potentially improving dyspnoea and quality of life in this patient group. Methods We conducted a randomised trial with assessor-blinding and intention-to-treat analysis. Following 48? €...hours of successful weaning, 70 participants (mechanically ventilated =7 days) were randomised to receive inspiratory muscle training once daily 5 days/week for 2 weeks in addition to usual care, or usual care (control). Primary endpoints were inspiratory muscle strength and fatigue resistance index (FRI) 2 weeks following enrolment. Secondary endpoints included dyspnoea, physical function and quality of life, post-intensive care length of stay and in-hospital mortality. Results 34 participants were randomly allocated to the training group and 36 to control. The training group demonstrated greater improvements in inspiratory strength (training: 17%, control: 6%, mean difference: 11%, p=0.02). There were no statistically significant differences in FRI (0.03 vs 0.02, p=0.81), physical function (0.25 vs 0.25, p=0.97) or dyspnoea ('0.5 vs 0.2, p=0.22). Improvement in quality of life was greater in the training group (14% vs 2%, mean difference 12%, p=0.03). In-hospital mortality was higher in the training group (4 vs 0, 12% vs 0%, p=0.051). Conclusions Inspiratory muscle training following successful weaning increases inspiratory muscle strength and quality of life, but we cannot confidently rule out an associated increased risk of in-hospital mortality. Trial registration number ACTRN12610001089022, results.
AB - Background In patients who have been mechanically ventilated, inspiratory muscles remain weak and fatigable following ventilatory weaning, which may contribute to dyspnoea and limited functional recovery. Inspiratory muscle training may improve inspiratory muscle strength and endurance following weaning, potentially improving dyspnoea and quality of life in this patient group. Methods We conducted a randomised trial with assessor-blinding and intention-to-treat analysis. Following 48? €...hours of successful weaning, 70 participants (mechanically ventilated =7 days) were randomised to receive inspiratory muscle training once daily 5 days/week for 2 weeks in addition to usual care, or usual care (control). Primary endpoints were inspiratory muscle strength and fatigue resistance index (FRI) 2 weeks following enrolment. Secondary endpoints included dyspnoea, physical function and quality of life, post-intensive care length of stay and in-hospital mortality. Results 34 participants were randomly allocated to the training group and 36 to control. The training group demonstrated greater improvements in inspiratory strength (training: 17%, control: 6%, mean difference: 11%, p=0.02). There were no statistically significant differences in FRI (0.03 vs 0.02, p=0.81), physical function (0.25 vs 0.25, p=0.97) or dyspnoea ('0.5 vs 0.2, p=0.22). Improvement in quality of life was greater in the training group (14% vs 2%, mean difference 12%, p=0.03). In-hospital mortality was higher in the training group (4 vs 0, 12% vs 0%, p=0.051). Conclusions Inspiratory muscle training following successful weaning increases inspiratory muscle strength and quality of life, but we cannot confidently rule out an associated increased risk of in-hospital mortality. Trial registration number ACTRN12610001089022, results.
KW - Exercise
KW - Respiratory Measurement
KW - Respiratory Muscles
KW - Dyspnea/etiology
KW - Single-Blind Method
KW - Ventilator Weaning/methods
KW - Respiratory Therapy/methods
KW - Humans
KW - Middle Aged
KW - Length of Stay/statistics & numerical data
KW - Male
KW - Inhalation/physiology
KW - Breathing Exercises/methods
KW - Quality of Life
KW - Adult
KW - Female
KW - Aged
KW - Respiration, Artificial/adverse effects
KW - Patient Compliance
KW - Respiratory Muscles/physiopathology
UR - http://www.scopus.com/inward/record.url?scp=84973279175&partnerID=8YFLogxK
UR - http://www.mendeley.com/research/inspiratory-muscle-training-enhance-recovery-mechanical-ventilation-randomised-trial
U2 - 10.1136/thoraxjnl-2016-208279
DO - 10.1136/thoraxjnl-2016-208279
M3 - Article
SN - 0040-6376
VL - 71
SP - 812
EP - 819
JO - Thorax
JF - Thorax
IS - 9
ER -