Inspiratory Muscle Training in Weaning

NCT00922493 | Completed Phase 4

• 1 other identifier: 250525
• Study Type: interventional
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

Background: the objective of the present inquiry was to evaluate the weaning process in intubated older people subjected to inspiratory muscle training and to correlate the predictors of ventilatory interruption with its success. Methods: the patients were divided randomly into an experimental group (EG, n=14; age=82±4 years) that received conventional physiotherapy plus inspiratory muscle training (IMT) with threshold IMT® and a control group (CG, n=14; age=81±6 years) that received only conventional physiotherapy. The predictors evaluates were the maximum inspiratory pressure (MIP) and the index of Tobin (IT). The protocol for muscle training consisted of an initial load of 30% MIP, which was increased by 10% daily; training was administered for five minutes, twice a day, seven times a week with supplemental oxygen for the entire period from the decision to wean up to extubation.

Conditions

Weaning

Keywords

weaning; inspiratory muscle training; maximum inspiratory pressure (MIP); index of Tobin (IT); intubated; intensive care unit; elderly

Outcome Measures

Primary Outcomes (1)

• Measurement of the MIP

Secondary Outcomes (1)

• Measurement of rapid shallow breathing (IT)

Interventions

inspiratory muscle training OTHER

Protocol of inspiratory muscle training using threshold IMT®: After the MIP was measured, inspiratory muscle training was initiated. The Threshold-IMT® device of a linear pressure load produces a resistance to inspiration through the use of a flow-independent one-way valve. During expiration there is no resistance because the unidirectional valve opens, while during inspiration the valve closes, becoming "hard" due to the resistance of the spring. The suggested protocol was: initial load of 30% of the M24, increasing daily by 10%, with training for five minutes, twice a day, seven times a week in the period from the beginning of the weaning from the MV until the extubation of the patient. An essential factor was the use of supplemental oxygen (O2) as needed by the patient. The patients were in DD with fowler 45º.

Eligibility Criteria

• Age: 60 Years - 90 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• the individuals of the sample were required to have undergone Mechanical Ventilation for at least 48 hours in a controlled way
• intubation is diagnostic for acute respiratory injury type 1
• has a maximum value of MIP of -20 cmH2O16

You may not qualify if:

• any type of acute condition (cardiac arrhythmia) or chronic condition, such as insufficient congestive heart failure or unstable ischemic cardiac disease, that could compromise weaning or could impede the accomplishment of inspiratory muscle training (neuropathy and myopathy).
• Tracheostomized patients (in the pre-test).
• patients with neurological problems (cerebral vascular accident, cerebrospinal trauma or spinal medullar trauma.
• patients with morbid obesity
• patients taking medicine that could cause a disorder of attention.
• cases of auto-extubation.

Sponsors & Collaborators

• Euro-American Network of Human Kinetics: lead

Study Sites (1)

Quinta D'or Hospital

Rio de Janeiro, Rio de Janeiro, 22790-140, Brazil

Location

Related Publications (1)

• Cader SA, Vale RG, Castro JC, Bacelar SC, Biehl C, Gomes MC, Cabrer WE, Dantas EH. Inspiratory muscle training improves maximal inspiratory pressure and may assist weaning in older intubated patients: a randomised trial. J Physiother. 2010;56(3):171-7. doi: 10.1016/s1836-9553(10)70022-9.

  PMID: 20795923 DERIVED

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Intervention Model: PARALLEL
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: June 15, 2009
• First Posted: June 17, 2009
• Study Start: December 1, 2007
• Study Completion: November 1, 2008
• Last Updated: June 18, 2009

Record last verified: 2009-06

Locations

BR (1)