Specific inspiratory muscle training is safe in selected patients who are ventilator-dependent

A case series

Bernie Bissett, Anne I. Leditschke, Margot Green

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Mechanical ventilation of intensive care patients results in inspiratory muscle weakness. Inspiratory muscle training may be useful, but no studies have specifically described the physiological response to training. Research questions: Is inspiratory muscle training with a threshold device safe in selected ventilator-dependent patients? Does inspiratory muscle strength increase with high-intensity inspiratory muscle training in ventilator-dependent patients? Design: Prospective cohort study of 10 medically stable ventilator-dependent adult patients. Setting: Tertiary adult intensive care unit. Methods: Inspiratory muscle training 5-6 days per week with a threshold device attached to the tracheostomy without supplemental oxygen. Outcome measures: Physiological response to training (heart rate, mean arterial pressure, oxygen saturation and respiratory rate), adverse events, training pressures. Results: No adverse events were recorded in 195 sessions studied. For each patient's second training session, no significant changes in heart rate (Mean Difference 1.3bpm, 95% CI -2.7 to 5.3), mean arterial pressure (Mean Difference -0.9mmHg, 95% CI -6.4 to 4.6), respiratory rate (Mean Difference 1.2bpm, 95% CI -1.1 to 3.5bpm) or oxygen saturation (Mean Difference 1.2%, 95% CI -0.6 to 3.0) were detected Training pressures increased significantly (Mean Difference 18.6cmH 2O, 95% CI 11.8-25.3). Conclusion: Threshold-based inspiratory muscle training can be delivered safely in selected ventilator-dependent patients without supplemental oxygen. Inspiratory muscle training is associated with increased muscle strength, which may assist ventilatory weaning.

Original languageEnglish
Pages (from-to)98-104
Number of pages7
JournalIntensive and Critical Care Nursing
Volume28
Issue number2
DOIs
Publication statusPublished - Apr 2012
Externally publishedYes

Fingerprint

Mechanical Ventilators
Muscles
Oxygen
Muscle Strength
Respiratory Rate
Arterial Pressure
Heart Rate
Pressure
Equipment and Supplies
Tracheostomy
Muscle Weakness
Critical Care
Weaning
Artificial Respiration
Intensive Care Units
Cohort Studies
Outcome Assessment (Health Care)
Prospective Studies
Research

Cite this

@article{cc476d05521144ff8df4c831a65974f2,
title = "Specific inspiratory muscle training is safe in selected patients who are ventilator-dependent: A case series",
abstract = "Background: Mechanical ventilation of intensive care patients results in inspiratory muscle weakness. Inspiratory muscle training may be useful, but no studies have specifically described the physiological response to training. Research questions: Is inspiratory muscle training with a threshold device safe in selected ventilator-dependent patients? Does inspiratory muscle strength increase with high-intensity inspiratory muscle training in ventilator-dependent patients? Design: Prospective cohort study of 10 medically stable ventilator-dependent adult patients. Setting: Tertiary adult intensive care unit. Methods: Inspiratory muscle training 5-6 days per week with a threshold device attached to the tracheostomy without supplemental oxygen. Outcome measures: Physiological response to training (heart rate, mean arterial pressure, oxygen saturation and respiratory rate), adverse events, training pressures. Results: No adverse events were recorded in 195 sessions studied. For each patient's second training session, no significant changes in heart rate (Mean Difference 1.3bpm, 95{\%} CI -2.7 to 5.3), mean arterial pressure (Mean Difference -0.9mmHg, 95{\%} CI -6.4 to 4.6), respiratory rate (Mean Difference 1.2bpm, 95{\%} CI -1.1 to 3.5bpm) or oxygen saturation (Mean Difference 1.2{\%}, 95{\%} CI -0.6 to 3.0) were detected Training pressures increased significantly (Mean Difference 18.6cmH 2O, 95{\%} CI 11.8-25.3). Conclusion: Threshold-based inspiratory muscle training can be delivered safely in selected ventilator-dependent patients without supplemental oxygen. Inspiratory muscle training is associated with increased muscle strength, which may assist ventilatory weaning.",
keywords = "Inspiratory muscle training, Intensive care, Physiotherapy, Safety, Ventilator weaning methods",
author = "Bernie Bissett and Leditschke, {Anne I.} and Margot Green",
year = "2012",
month = "4",
doi = "10.1016/j.iccn.2012.01.003",
language = "English",
volume = "28",
pages = "98--104",
journal = "Intensive Care Nursing",
issn = "0964-3397",
publisher = "Churchill Livingstone",
number = "2",

}

Specific inspiratory muscle training is safe in selected patients who are ventilator-dependent : A case series. / Bissett, Bernie; Leditschke, Anne I.; Green, Margot.

In: Intensive and Critical Care Nursing, Vol. 28, No. 2, 04.2012, p. 98-104.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Specific inspiratory muscle training is safe in selected patients who are ventilator-dependent

T2 - A case series

AU - Bissett, Bernie

AU - Leditschke, Anne I.

AU - Green, Margot

PY - 2012/4

Y1 - 2012/4

N2 - Background: Mechanical ventilation of intensive care patients results in inspiratory muscle weakness. Inspiratory muscle training may be useful, but no studies have specifically described the physiological response to training. Research questions: Is inspiratory muscle training with a threshold device safe in selected ventilator-dependent patients? Does inspiratory muscle strength increase with high-intensity inspiratory muscle training in ventilator-dependent patients? Design: Prospective cohort study of 10 medically stable ventilator-dependent adult patients. Setting: Tertiary adult intensive care unit. Methods: Inspiratory muscle training 5-6 days per week with a threshold device attached to the tracheostomy without supplemental oxygen. Outcome measures: Physiological response to training (heart rate, mean arterial pressure, oxygen saturation and respiratory rate), adverse events, training pressures. Results: No adverse events were recorded in 195 sessions studied. For each patient's second training session, no significant changes in heart rate (Mean Difference 1.3bpm, 95% CI -2.7 to 5.3), mean arterial pressure (Mean Difference -0.9mmHg, 95% CI -6.4 to 4.6), respiratory rate (Mean Difference 1.2bpm, 95% CI -1.1 to 3.5bpm) or oxygen saturation (Mean Difference 1.2%, 95% CI -0.6 to 3.0) were detected Training pressures increased significantly (Mean Difference 18.6cmH 2O, 95% CI 11.8-25.3). Conclusion: Threshold-based inspiratory muscle training can be delivered safely in selected ventilator-dependent patients without supplemental oxygen. Inspiratory muscle training is associated with increased muscle strength, which may assist ventilatory weaning.

AB - Background: Mechanical ventilation of intensive care patients results in inspiratory muscle weakness. Inspiratory muscle training may be useful, but no studies have specifically described the physiological response to training. Research questions: Is inspiratory muscle training with a threshold device safe in selected ventilator-dependent patients? Does inspiratory muscle strength increase with high-intensity inspiratory muscle training in ventilator-dependent patients? Design: Prospective cohort study of 10 medically stable ventilator-dependent adult patients. Setting: Tertiary adult intensive care unit. Methods: Inspiratory muscle training 5-6 days per week with a threshold device attached to the tracheostomy without supplemental oxygen. Outcome measures: Physiological response to training (heart rate, mean arterial pressure, oxygen saturation and respiratory rate), adverse events, training pressures. Results: No adverse events were recorded in 195 sessions studied. For each patient's second training session, no significant changes in heart rate (Mean Difference 1.3bpm, 95% CI -2.7 to 5.3), mean arterial pressure (Mean Difference -0.9mmHg, 95% CI -6.4 to 4.6), respiratory rate (Mean Difference 1.2bpm, 95% CI -1.1 to 3.5bpm) or oxygen saturation (Mean Difference 1.2%, 95% CI -0.6 to 3.0) were detected Training pressures increased significantly (Mean Difference 18.6cmH 2O, 95% CI 11.8-25.3). Conclusion: Threshold-based inspiratory muscle training can be delivered safely in selected ventilator-dependent patients without supplemental oxygen. Inspiratory muscle training is associated with increased muscle strength, which may assist ventilatory weaning.

KW - Inspiratory muscle training

KW - Intensive care

KW - Physiotherapy

KW - Safety

KW - Ventilator weaning methods

UR - http://www.scopus.com/inward/record.url?scp=84858752767&partnerID=8YFLogxK

U2 - 10.1016/j.iccn.2012.01.003

DO - 10.1016/j.iccn.2012.01.003

M3 - Article

VL - 28

SP - 98

EP - 104

JO - Intensive Care Nursing

JF - Intensive Care Nursing

SN - 0964-3397

IS - 2

ER -