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机械通气成年患者的呼吸肌训练:基于当前证据制定精确方案:一项范围综述

Respiratory Muscle Training in Mechanically Ventilated Adult Patients: Toward a Precise Prescription Based on Current Evidence: A Scoping Review.

作者信息

Carabalí-Rivera Jennifer Andrea, Salazar-Muñoz Valeria, Villanueva-Londoño Evelyn Dayana, González-Ruiz Katherine, Arzayus-Patiño Leonardo

机构信息

Physiotherapy Program, Faculty of Health, Universidad Santiago de Cali, Cali 760035, Colombia.

出版信息

J Clin Med. 2025 Jul 17;14(14):5058. doi: 10.3390/jcm14145058.

Abstract

Respiratory muscle training (RMT) has been proposed as a supportive strategy for adults receiving invasive mechanical ventilation; however, the way RMT is prescribed-mode, intensity, frequency, and volume-remains highly heterogeneous. : This study aimed to describe the current evidence regarding the prescription of respiratory muscle strengthening in terms of frequency, intensity, method, and volume in adult patients under mechanical ventilation in intensive care units. : A scoping review was conducted following the PRISMA-ScR guidelines based on searches in electronic databases including Scopus, SciELO, ScienceDirect, PubMed, LILACS, Springer, Web of Science, Google Scholar, PEDro, Dialnet, and Cochrane. : Seven studies met the established inclusion criteria and described prescription protocols for respiratory muscle strengthening in adult patients under mechanical ventilation in intensive care units. : The most frequently reported protocol involved threshold load training at 40-50% of maximal inspiratory pressure, administered twice daily, every day of the week, with a volume of 30 repetitions. This intervention showed promising results in improving inspiratory muscle strength, with potential additional benefits in weaning success and pulmonary function.

摘要

呼吸肌训练(RMT)已被提议作为接受有创机械通气的成年人的一种支持性策略;然而,RMT的处方方式——模式、强度、频率和量——仍然高度异质。本研究旨在描述关于重症监护病房接受机械通气的成年患者呼吸肌强化处方在频率、强度、方法和量方面的现有证据。根据PRISMA-ScR指南,通过在包括Scopus、SciELO、ScienceDirect、PubMed、LILACS、Springer、Web of Science、Google Scholar、PEDro、Dialnet和Cochrane在内的电子数据库中进行检索,开展了一项范围综述。七项研究符合既定的纳入标准,并描述了重症监护病房接受机械通气的成年患者呼吸肌强化的处方方案。最常报告的方案是阈负荷训练,在最大吸气压力的40%-50%下进行,每天两次,每周七天,量为30次重复。该干预在改善吸气肌力量方面显示出有前景的结果,在撤机成功率和肺功能方面可能还有额外益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65bf/12295891/114717e7cac3/jcm-14-05058-g001.jpg

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