Effect of Inspiratory Muscle Training on Duration of Mechanical Ventilation Support



Status:Completed
Conditions:Pulmonary
Therapuetic Areas:Pulmonary / Respiratory Diseases
Healthy:No
Age Range:18 - Any
Updated:11/30/2013
Start Date:May 2010
End Date:December 2013
Contact:A. D Martin, PhD, PT
Email:dmartin@phhp.ufl.edu
Phone:3273-273-6105

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Inspiratory Muscle Strength Training in Ventilator Dependent Patients


A growing body of knowledge has documented that the diaphragm, the primary muscle of
breathing, atrophies and weakens within days of instituting mechanical ventilation support.
Diaphragm weakness has been implicated as a major contributor to difficulty with weaning, or
breathing without ventilator support. This study will test whether instituting a diaphragm
strength training rehabilitation program will reduce the time patients require mechanical
ventilation in a surgical intensive care setting.


Inclusion Criteria:

1. Admission to general surgical intensive care unit with respiratory failure and expected
to require mechanical ventilation support for more than 72 hours.

Exclusion Criteria:

1. inability to follow simple, one step commands such as "inspire forcefully",

2. patients with prior arrangements to be transferred to other facilities when
stabilized,

3. any contraindications to disconnecting pt from ventilator for SHAM or IMST treatment,

4. unstable or difficult airway upon ICU admission and predicted to last for more than
72 hours,

5. use of more than minimal vasopressor or vasodilatatory agents as a continuous
infusion,

6. severe dysrhythmias,

7. acute coronary syndrome

8. pulmonary contraindications (pneumon/hemothorax, flail chest),

9. acute surgical problems arising in the immediate post operative period (serious
postoperative bleeding, wound dehiscence, etc). When and if these problems resolve
and the patient meets other entry criteria, they will be eligible to be recruited for
participation.

10. active neuromuscular diseases that would prevent or interfere with responding to
strength training (e.g., amyotrophic lateral sclerosis, multiple sclerosis,
myasthenia gravis, polymyositis, muscular dystrophy or other dystrophies and
myopathies)

11. spinal cord injuries.
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