Inspiratory muscle training facilitates liberation from mechanical ventilation in subacute critically ill patients—a randomized controlled trial
BackgroundPatients undergoing mechanical ventilation often develop rapid diaphragmatic atrophy, respiratory muscle weakness, and dysfunction, which are associated with prolonged duration of ventilation. This study aimed to evaluate whether Inspiratory Muscle Training (IMT) facilitates weaning from m...
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Frontiers Media S.A.
2025-01-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2024.1503678/full |
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| author | Shu-Jane Wang Tien-Pei Fang Tien-Pei Fang Daniel D. Rowley Nan-Wei Liu Jui-O Chen Jui-Fang Liu Jui-Fang Liu Hui-Ling Lin Hui-Ling Lin Hui-Ling Lin |
| author_facet | Shu-Jane Wang Tien-Pei Fang Tien-Pei Fang Daniel D. Rowley Nan-Wei Liu Jui-O Chen Jui-Fang Liu Jui-Fang Liu Hui-Ling Lin Hui-Ling Lin Hui-Ling Lin |
| author_sort | Shu-Jane Wang |
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| description | BackgroundPatients undergoing mechanical ventilation often develop rapid diaphragmatic atrophy, respiratory muscle weakness, and dysfunction, which are associated with prolonged duration of ventilation. This study aimed to evaluate whether Inspiratory Muscle Training (IMT) facilitates weaning from mechanical ventilation and enhances muscle strength in critically ill, subacute adult patients, while examining the relationship between IMT and relevant clinical laboratory values.MethodsIn this randomized clinical trial, patients admitted to the intensive care unit requiring mechanical ventilation for more than 2 days, with stable hemodynamics and resolved acute conditions, were enrolled. Participants were randomly assigned to the IMT or no-IMT group. The IMT group received training twice daily, 5 days a week, for three consecutive weeks. The primary outcome was ventilator duration. The primary outcome measure was the number of days until liberation from mechanical ventilation. The secondary outcomes of interest were respiratory muscle strength and biomarker levels.ResultsThirty-three subjects (17 in the IMT group, 16 in the no-IMT group) were included in the final analysis. The IMT group had significantly shorter ventilator days (12.6 ± 5.2 vs. 18.1 ± 8.8, p = 0.04). IMT intervention significantly reduced rapid shallow breathing index and improved respiratory muscle strength, with greater maximum inspiratory pressure (p < 0.01), maximum expiratory pressure (p = 0.03), and peak expiratory flow (p = 0.01). A moderate positive correlation was observed between IMT and increased creatinine levels (rs = 0.54, p = 0.01), whereas the no-IMT group showed a reduction.ConclusionIMT significantly shortened ventilator duration and improved respiratory muscle strength. A moderate correlation between increased creatinine levels and respiratory muscle strength was observed, suggesting that creatinine may be a potential biomarker for muscle recovery during IMT.Clinical trial registrationThis study was registered at ClinicalTrials.gov (NCT06611683). |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-7f1fe42ed7684f9c88cf89ad383695112025-01-29T12:57:36ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-01-011110.3389/fmed.2024.15036781503678Inspiratory muscle training facilitates liberation from mechanical ventilation in subacute critically ill patients—a randomized controlled trialShu-Jane Wang0Tien-Pei Fang1Tien-Pei Fang2Daniel D. Rowley3Nan-Wei Liu4Jui-O Chen5Jui-Fang Liu6Jui-Fang Liu7Hui-Ling Lin8Hui-Ling Lin9Hui-Ling Lin10Department of Respiratory Therapy, Zuoying Armed Forces General Hospital, Kaohsiung, TaiwanDepartment of Respiratory Therapy, Chiayi Chang Gung Memorial Hospital, Chiayi, TaiwanDepartment of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, TaiwanRespiratory Therapy Services, University of Virginia Medical Center, Charlottesville, VA, United StatesDepartment of English, National Chengchi University, Taipei, TaiwanDepartment of Nursing, Tajen University, Pingtung, TaiwanDepartment of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, TaiwanChronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology, Chiayi, TaiwanDepartment of Respiratory Therapy, Chiayi Chang Gung Memorial Hospital, Chiayi, TaiwanDepartment of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, TaiwanDepartment of Respiratory Therapy, Chang Gung University, Taoyuan, TaiwanBackgroundPatients undergoing mechanical ventilation often develop rapid diaphragmatic atrophy, respiratory muscle weakness, and dysfunction, which are associated with prolonged duration of ventilation. This study aimed to evaluate whether Inspiratory Muscle Training (IMT) facilitates weaning from mechanical ventilation and enhances muscle strength in critically ill, subacute adult patients, while examining the relationship between IMT and relevant clinical laboratory values.MethodsIn this randomized clinical trial, patients admitted to the intensive care unit requiring mechanical ventilation for more than 2 days, with stable hemodynamics and resolved acute conditions, were enrolled. Participants were randomly assigned to the IMT or no-IMT group. The IMT group received training twice daily, 5 days a week, for three consecutive weeks. The primary outcome was ventilator duration. The primary outcome measure was the number of days until liberation from mechanical ventilation. The secondary outcomes of interest were respiratory muscle strength and biomarker levels.ResultsThirty-three subjects (17 in the IMT group, 16 in the no-IMT group) were included in the final analysis. The IMT group had significantly shorter ventilator days (12.6 ± 5.2 vs. 18.1 ± 8.8, p = 0.04). IMT intervention significantly reduced rapid shallow breathing index and improved respiratory muscle strength, with greater maximum inspiratory pressure (p < 0.01), maximum expiratory pressure (p = 0.03), and peak expiratory flow (p = 0.01). A moderate positive correlation was observed between IMT and increased creatinine levels (rs = 0.54, p = 0.01), whereas the no-IMT group showed a reduction.ConclusionIMT significantly shortened ventilator duration and improved respiratory muscle strength. A moderate correlation between increased creatinine levels and respiratory muscle strength was observed, suggesting that creatinine may be a potential biomarker for muscle recovery during IMT.Clinical trial registrationThis study was registered at ClinicalTrials.gov (NCT06611683).https://www.frontiersin.org/articles/10.3389/fmed.2024.1503678/fullinspiratory muscle trainingsubacute critical illmechanical ventilation supportrapid shallow breathing indexrespiratory muscle strengthcreatinine |
| spellingShingle | Shu-Jane Wang Tien-Pei Fang Tien-Pei Fang Daniel D. Rowley Nan-Wei Liu Jui-O Chen Jui-Fang Liu Jui-Fang Liu Hui-Ling Lin Hui-Ling Lin Hui-Ling Lin Inspiratory muscle training facilitates liberation from mechanical ventilation in subacute critically ill patients—a randomized controlled trial Frontiers in Medicine inspiratory muscle training subacute critical ill mechanical ventilation support rapid shallow breathing index respiratory muscle strength creatinine |
| title | Inspiratory muscle training facilitates liberation from mechanical ventilation in subacute critically ill patients—a randomized controlled trial |
| title_full | Inspiratory muscle training facilitates liberation from mechanical ventilation in subacute critically ill patients—a randomized controlled trial |
| title_fullStr | Inspiratory muscle training facilitates liberation from mechanical ventilation in subacute critically ill patients—a randomized controlled trial |
| title_full_unstemmed | Inspiratory muscle training facilitates liberation from mechanical ventilation in subacute critically ill patients—a randomized controlled trial |
| title_short | Inspiratory muscle training facilitates liberation from mechanical ventilation in subacute critically ill patients—a randomized controlled trial |
| title_sort | inspiratory muscle training facilitates liberation from mechanical ventilation in subacute critically ill patients a randomized controlled trial |
| topic | inspiratory muscle training subacute critical ill mechanical ventilation support rapid shallow breathing index respiratory muscle strength creatinine |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2024.1503678/full |
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