title: Specific inspiratory muscle training is safe in selected patients who are ventilator-dependent: a case series.
abstract: BACKGROUND
  Mechanical ventilation of intensive care patients results in inspiratory muscle weakness. Inspiratory muscle training may be useful, but no studies have specifically described the physiological response to training.
  
  
  OBJECTIVE
  Is inspiratory muscle training with a threshold device safe in selected ventilator-dependent patients? Does inspiratory muscle strength increase with high-intensity inspiratory muscle training in ventilator-dependent patients?
  
  
  METHODS
  Prospective cohort study of 10 medically stable ventilator-dependent adult patients.
  
  
  METHODS
  Tertiary adult intensive care unit.
  
  
  METHODS
  Inspiratory muscle training 5-6 days per week with a threshold device attached to the tracheostomy without supplemental oxygen.
  
  
  METHODS
  Physiological response to training (heart rate, mean arterial pressure, oxygen saturation and respiratory rate), adverse events, training pressures.
  
  
  RESULTS
  No adverse events were recorded in 195 sessions studied. For each patient's second training session, no significant changes in heart rate (Mean Difference 1.3 bpm, 95% CI -2.7 to 5.3), mean arterial pressure (Mean Difference -0.9 mmHg, 95% CI -6.4 to 4.6), respiratory rate (Mean Difference 1.2 bpm, 95% CI -1.1 to 3.5 bpm) or oxygen saturation (Mean Difference 1.2%, 95% CI -0.6 to 3.0) were detected Training pressures increased significantly (Mean Difference 18.6 cmH(2)O, 95% CI 11.8-25.3).
  
  
  CONCLUSIONS
  Threshold-based inspiratory muscle training can be delivered safely in selected ventilator-dependent patients without supplemental oxygen. Inspiratory muscle training is associated with increased muscle strength, which may assist ventilatory weaning.
authors.affiliation: Physiotherapy Department, Canberra Hospital, Australia. Bernie.Bissett@act.gov.au
authors.forename: Bernie
authors.initials: B
authors.lastname: Bissett
authors.forename: I Anne
authors.initials: IA
authors.lastname: Leditschke
authors.forename: Margot
authors.initials: M
authors.lastname: Green
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001945:Breathing Exercises / Q000009:adverse effects; D015331:Cohort Studies; D003422:Critical Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000534:rehabilitation*; D010353:Patient Education as Topic / Q000379:methods*; D026741:Physical Therapy Modalities; D012121:Respiration, Artificial; D012132:Respiratory Muscles / Q000503:physiopathology*; D012138:Respiratory Therapy / Q000379:methods*; D055815:Young Adult