Inspiratory and Expiratory Muscle Training in Critically Ill Patients Weaned From Mechanical Ventilation
试验速览
- 阶段
- 不适用
- 入组人数
- 100
- 试验地点
- 1
- 主要终点
- change in inspiratory muscle strength
研究概览
简要总结
Respiratory muscle weakness is common after mechanical ventilation and occurs early. This can limit functional recovery. Respiratory muscle training is often neglected in clinical practice. Some data indicates that inspiratory muscle training increases inspiratory muscle strength and quality of life. The aim of the study is to assess the impact of combined inspiratory and expiratory muscle training on inspiratory muscle strength. The second aim is to assess the impact of this training program on expiratory muscle strength.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- Single (Participant)
盲法说明
patients are masked: they will all benefit from respiratory physiotherapy, with placebo or real muscle training investigator and care providers are unmasked, as they set the training parameters
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- Male
- 接受健康志愿者
- 否
入选标准
- •patient from mechanical ventilation after at least 24 hours of support
- •collaborative patient
排除标准
- •confusion, mental disorder
- •not french speaking
- •pulmonary surgery in the past 12 months
- •external ventricular drain
- •previous pneumothorax or pneumothorax not drained
- •rib fractures
- •alveolar hemorrhage
- •hemodynamic instability
- •labial occlusion impossible (face burn, facial paralysis)
- •patient refusal
研究组 & 干预措施
Trained group
Patients will benefit from usual respiratory physiotherapy (secretion clearance treatment and recruitment maneuvers), and muscle training. This program will be delivered 5 days a week.
Inspiratory muscle training (IMT): using a threshold IMT device with mouthpiece, 5 sets of 6 breaths, intensity is prescribed at 60% of maximal inspiratory pressure for the first set, and then increased to the highest tolerable intensity to allow completion of the 6th breath Expiratory muscle training (EMT): using a bottle filled with water, starting at 5cm and then increased to 8 cm gradually, 5 sets of 6 breaths
Training program starts after mechanical ventilation weaning, as soon as the patient is collaborative, and is continued until 1 month after ICU discharge
干预措施: inspiratory and expiratory muscle training (Procedure)
Untrained group
Patients will benefit from usual respiratory physiotherapy (secretion clearance treatment and recruitment maneuvers), and muscle exercises that are not planned to train muscles. This program will be delivered 5 days a week.
Inspiratory exercises: fractionated inspiration, 5 sets of 6 breaths Expiratory exercises: using a bottle filled with water (1 cm)
Exercises program starts after mechanical ventilation weaning, as soon as the patient is collaborative, and is continued until 1 month after ICU discharge
干预措施: inspiratory and expiratory exercises (Procedure)
结局指标
主要结局
change in inspiratory muscle strength
时间窗: 1 month after ICU discharge (compared to ICU discharge)
measurement of maximal inspiratory pressure
change in inspiratory muscle strength
时间窗: between 7 to 15 days after ICU discharge (compared to ICU discharge)
measurement of maximal inspiratory pressure
次要结局
- change in expiratory muscle strength(1 month after ICU discharge (compared to ICU discharge))
- respiratory infections(1 month after ICU discharge)
- change in dyspnea perception(1 month after ICU discharge (compared to hospital discharge))
- impact of dyspnea on physical activities(1 month after ICU discharge)
- change in expiratory muscle strength(between 7 to 15 days after ICU discharge (compared to ICU discharge))
- impact of dyspnea on physical activities(between 7 to 15 days after ICU discharge)
研究者
Rousseau
Head of clinic
University of Liege