The Effectiveness of Inspiratory Muscle Training in Weaning Critically Ill Patients from Mechanical Ventilation
Keywords:mechanical ventilation, critical illness, inspiratory muscle training, weaning, intensive care unit
BACKGROUND: Inspiratory muscle weakness is a consequence of mechanical ventilation that contributes to weaning failure in critical ill patients. Since 1980, case reports of inspiratory muscle training (IMT) in ventilated, difficult to be weaned patients have proposed that this training strategy is associated with successful weaning.
OBJECTIVE: We evaluated the efficacy of the inspiratory muscle training on the weaning process.
METHODS: We conducted a literature search in the following databases: PubMed, EMBASE, Scopus and Google scholar. Selected keywords included inspiratory/ respiratory muscle training, weaning/failure, mechanical ventilation, critically ill, threshold load, intubated/ tracheostomy.
RESULTS: In our analysis we included three randomized control trials involving 150 patients. The studies used different devices of training and training protocols. Inspiratory muscle training significantly increased inspiratory muscle strength in relation to sham or no training.
CONCLUSION: Although IMT leads to significant increase of respiratory muscle strength, it has not yet been clearly demonstrated that this also leads to successful weaning. Further large randomized studies are needed to determine the beneficial effect of IMT in weaning patients from ventilatory support.
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