The effect of threshold inspiratory muscle training on the duration of weaning in intensive care unit-admitted patients: A randomized clinical trial

Farnoosh Khodabandeloo; Razieh Froutan; Arash Peivandi Yazdi; Mohammad Taghi Shakeri; Seyed Reza Mazlom; Ahmad Bagheri Moghaddam

doi:10.4103/jrms.jrms_757_22

The effect of threshold inspiratory muscle training on the duration of weaning in intensive care unit-admitted patients: A randomized clinical trial

J Res Med Sci. 2023 May 29:28:44. doi: 10.4103/jrms.jrms_757_22. eCollection 2023.

Authors

Farnoosh Khodabandeloo¹, Razieh Froutan^{2

3}, Arash Peivandi Yazdi^{4

5}, Mohammad Taghi Shakeri^{6

7}, Seyed Reza Mazlom², Ahmad Bagheri Moghaddam^{4

5}

Affiliations

¹ Medical Student, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
² Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
³ Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Iran.
⁴ Department of Anesthesiology and Critical Care, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
⁵ Surgical Oncology Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
⁶ Department of Epidemiology and Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
⁷ Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Background: The purpose of this study was to evaluate the effect of threshold inspiratory muscle training (IMT) on the duration of weaning in intensive care unit (ICU)-admitted patients.

Materials and methods: This randomized clinical trial enrolled 79 ICU-admitted, mechanically ventilated patients in 2020-2021 in Imam Reza Hospital, Mashhad. Patients were randomly divided into intervention (n = 40) and control (n = 39) groups. The intervention group received threshold IMT and conventional chest physiotherapy, while the control group only received conventional chest physiotherapy once a day. Before and after the end of the intervention, the strength of inspiratory muscles and the duration of weaning were measured in both the groups.

Results: The duration of weaning was shorter in the intervention group (8.4 ± 1.1 days) versus the control group (11.2 ± 0.6 days) (P < 0.001). The rapid shallow breathing index decreased by 46.5% in the intervention group and by 27.3% in the control group after the intervention (both P < 0.001), and the between-group comparison showed a significantly higher reduction in the intervention group than control group (P < 0.001). The patients' compliance after the intervention compared to the 1^st day increased to 16.2 ± 6.6 in the intervention group and 9.6 ± 6.8 in the control group (both P < 0.001), and the between-group comparison showed a significantly higher increase in the intervention group than control group. The maximum inspiratory pressure increased by 13.7 ± 6.1 in the intervention group and by 9.1 ± 6.0 in the control group (P < 0.001). Furthermore, the weaning success was 54% more probable in the intervention group than control group (P < 0.05).

Conclusion: The results of this study showed the positive effect of IMT with threshold IMT trainer on increased strength of respiratory muscles and reduced weaning duration.

Keywords: Admitted patients; inspiratory muscle training; intensive care unit; threshold IMT trainer; weaning.