The combination of inspiratory muscle training and high-flow nasal cannula oxygen therapy for promoting weaning outcomes in difficult-to-wean patients: protocol for a randomised controlled trial

According to the literature, 20-30% of intubated patients are difficult to wean off mechanical ventilation and have a prolonged intensive care unit (ICU) stay with detrimental effects on muscle strength, functional ability and quality of life. Inspiratory muscle training (IMT) a threshold device has...

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Bibliographic Details
Published in:	ERJ open research Vol. 6; no. 3; p. 88
Main Authors:	Patsaki, Irini, Christakou, Anna, Papadopoulos, Emmanouel, Katartzi, Martha, Kouvarakos, Alexandros, Siempos, Ilias, Tsimouris, Dimitris, Skoura, Anastasia, Xatzimina, Antonina, Malachias, Sotirios, Koulouris, Νikolaos, Grammatopoulou, Eirini, Zakinthinos, Spiros, Ischaki, Eleni
Format:	Journal Article
Language:	English
Published:	England European Respiratory Society 01-07-2020
Subjects:	Study Protocols
Online Access:	Get full text
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Summary:	According to the literature, 20-30% of intubated patients are difficult to wean off mechanical ventilation and have a prolonged intensive care unit (ICU) stay with detrimental effects on muscle strength, functional ability and quality of life. Inspiratory muscle training (IMT) a threshold device has been proposed as an effective exercise for minimising the effects of mechanical ventilation on respiratory muscles of critically ill patients with prolonged weaning. In addition, high-flow nasal cannula (HFNC) oxygen has been proved to provide efficient support for both high- and low-risk patients after extubation, thus preventing re-intubation. A randomised controlled trial was designed to assess the efficacy of combining IMT and HFNC as therapeutic strategies for patients with high risk for weaning failure. Once patients with prognostic factors of difficult weaning are awake, ventilated with support settings and cooperative, they will be randomised to one of the two following study groups: intervention group (IMT and HFNC) and control group (IMT and Venturi mask). IMT will start as soon as possible. Each allocated oxygen delivery device will be applied immediately after extubation. IMT intervention will continue until patients' discharge from ICU. The primary outcome is the rate of weaning failure. Secondary outcomes are maximal inspiratory and expiratory strength, endurance of respiratory muscles, global muscle strength, functional ability and quality of life along with duration of ventilation (days) and ICU and hospital length of stay. The present study could significantly contribute to knowledge of how best to treat patients with difficult weaning and high risk of re-intubation.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2312-0541 2312-0541
DOI:	10.1183/23120541.00088-2020