Physiotherapy Department, Canberra Hospital, Australia.
Intensive Crit Care Nurs. 2012 Apr;28(2):98-104. doi: 10.1016/j.iccn.2012.01.003. Epub 2012 Feb 15.
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.
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?
Prospective cohort study of 10 medically stable ventilator-dependent adult patients.
Tertiary adult intensive care unit.
Inspiratory muscle training 5-6 days per week with a threshold device attached to the tracheostomy without supplemental oxygen.
Physiological response to training (heart rate, mean arterial pressure, oxygen saturation and respiratory rate), adverse events, training pressures.
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).
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.
重症监护患者的机械通气会导致吸气肌力量减弱。吸气肌训练可能是有用的，但目前尚无研究专门描述训练的生理反应。
在选定的依赖呼吸机的患者中，使用阈值装置进行吸气肌训练是否安全？在依赖呼吸机的患者中，高强度吸气肌训练是否会增加吸气肌力量？
对 10 名医学稳定的依赖呼吸机的成年患者进行前瞻性队列研究。
三级成人重症监护病房。
使用阈值装置通过气管造口术进行每周 5-6 天的吸气肌训练，无需补充氧气。
训练的生理反应（心率、平均动脉压、氧饱和度和呼吸频率）、不良事件、训练压力。
在研究的 195 个训练中未记录到不良事件。对于每个患者的第二次训练，心率（平均差异 1.3 bpm，95%CI -2.7 至 5.3）、平均动脉压（平均差异 -0.9 mmHg，95%CI -6.4 至 4.6）、呼吸频率（平均差异 1.2 bpm，95%CI -1.1 至 3.5 bpm）或氧饱和度（平均差异 1.2%，95%CI -0.6 至 3.0）无显著变化。训练压力显著增加（平均差异 18.6 cmH2O，95%CI 11.8-25.3）。
在不补充氧气的情况下，使用基于阈值的吸气肌训练可以安全地应用于选定的依赖呼吸机的患者。吸气肌训练与肌肉力量的增加有关，这可能有助于呼吸机脱机。
