Impact of Inspiratory Muscle Training on Weaning Parameters in Prolonged Ventilator-Dependent Patients: A Preliminary Study

SAGE Open Nurs. 2022 Jul 7:8:23779608221111717. doi: 10.1177/23779608221111717. eCollection 2022 Jan-Dec.

Abstract

Introduction: Patients require prolonged mechanical ventilation to overcome respiratory failure in the chronic respiratory care ward; however, how to facilitate ventilator weaning using a nurse-led strategy is limited.

Objectives: This study aimed to examine the impact of adjusting ventilator trigger sensitivity as inspiratory muscle training on weaning parameters in patients with prolonged ventilator dependence.

Methods: Multiple pre-test-post-test with a non-equivalent control group design was conducted at a chronic respiratory care ward in southern Taiwan. A convenience sampling method was used to recruit patients who received prolonged mechanical ventilation for more than 21 days into control (n = 20) and intervention groups (n = 22). Adjustment of ventilator trigger sensitivity started from 10% of the initial maximum inspiratory pressure and increased to 40% after a training period of six weeks. The weaning parameters were collected for pre-test and multiple post-tests, and statistical analysis of treatment effects was performed using the generalized estimating equation.

Results: Magnitude of weaning parameters was significantly higher in the intervention group after the six-week training, including maximum inspiratory pressure, rapid shallow breathing index, tidal volume, and ratio of arterial-to-inspired oxygen.

Conclusion: Adjustment of ventilator trigger sensitivity as inspiratory muscle training can help prolonged ventilator-dependent patients improve their respiratory muscle strength, breathing patterns, and oxygenation.

Keywords: Prolonged mechanical ventilation; inspiratory muscle training; ventilator trigger sensitivity; ventilator-dependent patient; weaning parameters.