Inspiratory muscle training in difficult to wean patients

Mechanical ventilation (MV) is a life-saving treatment for critically ill patients on the intensive care unit but may have serious complications that are directly linked to the duration of MV. Weaning failure of MV can be the result of an imbalance between ventilator demands imposed upon the respiratory muscles and the capacity of the respiratory system to generate sufficient driving pressure to maintain tidal breathing. This capacity can be reduced due to respiratory muscle dysfunction. Thus respiratory muscle function can be associated with weaning failure from MV. Therefore, it has been hypothesized that patients with weaning failure might benefit from inspiratory muscle training (IMT). Evidence up to now has been limited to data from small, single, centre studies with heterogeneity in inclusion criteria, training modalities and outcomes. This project elaborate on the available methods for respiratory muscle assessment in critically ill patients to identify patients with respiratory muscle dysfunction. Second, it observes the incidence of weaning difficulties in UZLeuven according to the WIND (weaning according to a New Definition) classification. Since it is unclear whether the distribution proposed in the WIND classification is universally applicable or differs in specific settings and populations. Third, this project investigates the effects of a novel IMT method on weaning outcomes in difficult-to-wean patients. Furthermore, we investigate whether the novel IMT method with tapered flow resistive loading, provides a more optimal type of loading on the respiratory muscles than the commonly used mechanical threshold loading. The last objective was to gain insight into the effect of IMT on inspiratory muscle efficiency of difficult-to-wean patients. Up until now, this was only been investigated in healthy subjects and patients with chronic diseases. With this project, we believe to provide evidence on the effectiveness of inspiratory muscle training in patients with weaning difficulties and to reveal potentially underlying physiological mechanisms of IMT on improving the respiratory muscle efficiency.

Jaar van publicatie:2022

Toegankelijkheid:Closed