Short Effects of Speci|c Inspiratory Muscle Training and Early Mobilization in Prolonged Mechanically Ventilated Patients
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 46
- 试验地点
- 2
- 主要终点
- Maximum inspiratory pressure (MIP)
研究概览
简要总结
Using mechanical ventilation for more than 18 hours can affect respiratory muscle and postural muscle control, making it difficult to wean off the ventilator and reducing mobility. The aim of this study is to:
- Compare the effects of respiratory muscle strength training and early mobilization on dynamic lung compliance and maximum inspiratory pressure before and after a 7-day training period.
- Compare the success rate of weaning and the duration of weaning between the respiratory muscle strength training and the early mobilization program.
详细描述
The prolonged mechanical ventilation results in difficulty weaning off the ventilator. Inspiratory muscle strength and early mobilization can contribute to the expansion of lung parenchyma and facilitate success in weaning off respiratory support. Thus, this study aimed to explain the impact of inspiratory muscle training and early mobilization on dynamic lung compliance, spontaneous breathing time, and success rate in patients who have undergone mechanical ventilation for more than 48 hours.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 40 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients with respiratory diseases who have been on mechanical ventilation for more than 48 hours and are ready to be weaned off or undergoing weaning trials with continuous positive airway pressure (CPAP) or synchronized intermittent mandatory ventilation (SIMV).
- •The PaO2/FiO2 ratio is ≥ 150-200, with FiO2 ≤ 0.4-0.5 and PEEP ≤ 5-8 cmH2O, and a pH > 7.3 in blood plasma.
- •The age range is between 40 and 80 years old.
- •Patients exhibit good self-awareness and cooperation in training (Riker score of 4).
- •They can understand and communicate in Thai
排除标准
- •Clinical instability (HR > 120 beats/minute, RR > 30 breaths/minute, SatO2 < 90%, SBP > 140 mmHg or < 90 mmHg)
- •Patients who can be extubated and use non-invasive ventilation only or successfully extubated within the first 24 hours.
- •Patients with altered mental status (Glasgow Coma Score < 10) and inability to cooperate with training (Riker score < 4 or > 4)
- •Patients with limitations or contraindications such as inability to adjust the bed to a 45-degree angle or sit on the side of the bed, such as those with spinal cord injuries or recent head surgeries.
- •History of hemoptysis, pneumothorax
- •History of neuromuscular diseases causing muscle weakness and decreased sensation.
- •Patients with excessive cardiac stimulation (> 5 micrograms per kilogram per minute)
- •Heart rate > 140 beats per minute
- •Hemoglobin levels < 8-10 grams per deciliter
- •Patients with difficult airway issues.
结局指标
主要结局
Maximum inspiratory pressure (MIP)
时间窗: baseline and day 7 after program
MIP measurement using manometer, the device can be attached directly to the ETT or tracheostomy tube, and measures the pressure generated by patient on inhalation against a closed system.
Dynamic lung compliance (Cdyn)
时间窗: baseline and day 7 after program
Dynamic lung compliance refers to the ratio of the change in volume to the change in pressure over a tidal breath, with the pressure measured at moments of zero flow during breathing that recording from the mechanical ventilation
次要结局
- Weaning outcome(baseline and day 7 after program)
- chest wall expansion(baseline and day 7 after program)
- Grip strength(baseline and day 7 after program)
- Weaning time(baseline and day 7 after program)
研究者
Saikaew Chuachan
Department of Physical Therapy, Faculty of Medicine
Prince of Songkla University