title: Inspiratory muscle training did not accelerate weaning from mechanical ventilation but did improve tidal volume and maximal respiratory pressures: a randomised trial.
abstract: OBJECTIVE
  Does inspiratory muscle training accelerate weaning from mechanical ventilation? Does it improve respiratory muscle strength, tidal volume, and the rapid shallow breathing index?
  
  
  METHODS
  Randomised trial with concealed allocation and intention-to-treat analysis.
  
  
  METHODS
  92 patients receiving pressure support ventilation were included in the study and followed up until extubation, tracheostomy, or death.
  
  
  METHODS
  The experimental group received usual care and inspiratory muscle training using a threshold device, with a load of 40% of their maximal inspiratory pressure with a regimen of 5 sets of 10 breaths, twice a day, 7 days a week. The control group received usual care only.
  
  
  METHODS
  The primary outcome was the duration of the weaning period. The secondary outcomes were the changes in respiratory muscle strength, tidal volume, and the rapid shallow breathing index.
  
  
  RESULTS
  Although the weaning period was a mean of 8 hours shorter in the experimental group, this difference was not statistically significant (95% CI -16 to 32). Maximal inspiratory and expiratory pressures increased in the experimental group and decreased in the control group, with significant mean differences of 10cmH2O (95% CI 5 to 15) and 8cmH2O (95% CI 2 to 13), respectively. The tidal volume also increased in the experimental group and decreased in the control group (mean difference 72 ml, 95% CI 17 to 128). The rapid shallow breathing index did not differ significantly between the groups.
  
  
  CONCLUSIONS
  Inspiratory muscle training did not shorten the weaning period significantly but it increased respiratory muscle strength and tidal volume.
authors.affiliation: Division of Critical Care Medicine, Hospital de Clínicas de Porto Alegre, Brazil. rlcondessa@gmail.com
authors.forename: Robledo L
authors.initials: RL
authors.lastname: Condessa
authors.forename: Janete S
authors.initials: JS
authors.lastname: Brauner
authors.forename: Andressa L
authors.initials: AL
authors.lastname: Saul
authors.forename: Marcela
authors.initials: M
authors.lastname: Baptista
authors.forename: Ana C T
authors.initials: AC
authors.lastname: Silva
authors.forename: Sílvia R R
authors.initials: SR
authors.lastname: Vieira
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001945:Breathing Exercises; D003964:Diaphragm / Q000502:physiology; D006801:Humans; D001239:Inhalation / Q000502:physiology*; D008875:Middle Aged; D011312:Pressure; D012121:Respiration, Artificial; D012129:Respiratory Function Tests; D012132:Respiratory Muscles / Q000502:physiology; D012138:Respiratory Therapy / Q000379:methods*; D013990:Tidal Volume / Q000502:physiology*; D016896:Treatment Outcome; D015300:Ventilator Weaning / Q000379:methods*