Respiratory Muscle Training in ICU Patients

University of Liege

Status: Unknown

Conditions: Respiratory Muscle Training; Critical Illness; Inspiratory Muscle Strength; Mechanical Ventilation

Treatments: Procedure: inspiratory and expiratory exercises; Procedure: inspiratory and expiratory muscle training

Study type: Interventional

Funder types: Other

Identifiers

NCT04507451

RESP-USI

Details and patient eligibility

About

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.

Enrollment: 100 estimated patients

Sex: Male

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patient from mechanical ventilation after at least 24 hours of support
• collaborative patient

Exclusion criteria

• 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

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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100 participants in 2 patient groups, including a placebo group

Trained group

Experimental group

Description:

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

Treatment:

Procedure: inspiratory and expiratory muscle training

Untrained group

Placebo Comparator group

Description:

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

Treatment:

Procedure: inspiratory and expiratory exercises