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The combination of inspiratory muscle training and high-flow nasal cannula oxygen therapy for promoting weaning outcomes in difficult-to-wean patients: protocol for a randomised controlled trial
BACKGROUND: According to the literature, 20–30% of intubated patients are difficult to wean off mechanical ventilation and have a prolonged intensive care unit (ICU) stay with detrimental effects on muscle strength, functional ability and quality of life. Inspiratory muscle training (IMT) via a thre...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
European Respiratory Society
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7520168/ https://www.ncbi.nlm.nih.gov/pubmed/33015144 http://dx.doi.org/10.1183/23120541.00088-2020 |
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author | Patsaki, Irini Christakou, Anna Papadopoulos, Emmanouel Katartzi, Martha Kouvarakos, Alexandros Siempos, Ilias Tsimouris, Dimitris Skoura, Anastasia Xatzimina, Antonina Malachias, Sotirios Koulouris, Νikolaos Grammatopoulou, Eirini Zakinthinos, Spiros Ischaki, Eleni |
author_facet | Patsaki, Irini Christakou, Anna Papadopoulos, Emmanouel Katartzi, Martha Kouvarakos, Alexandros Siempos, Ilias Tsimouris, Dimitris Skoura, Anastasia Xatzimina, Antonina Malachias, Sotirios Koulouris, Νikolaos Grammatopoulou, Eirini Zakinthinos, Spiros Ischaki, Eleni |
author_sort | Patsaki, Irini |
collection | PubMed |
description | BACKGROUND: According to the literature, 20–30% of intubated patients are difficult to wean off mechanical ventilation and have a prolonged intensive care unit (ICU) stay with detrimental effects on muscle strength, functional ability and quality of life. Inspiratory muscle training (IMT) via a threshold device has been proposed as an effective exercise for minimising the effects of mechanical ventilation on respiratory muscles of critically ill patients with prolonged weaning. In addition, high-flow nasal cannula (HFNC) oxygen has been proved to provide efficient support for both high- and low-risk patients after extubation, thus preventing re-intubation. MATERIAL AND METHODS: A randomised controlled trial was designed to assess the efficacy of combining IMT and HFNC as therapeutic strategies for patients with high risk for weaning failure. Once patients with prognostic factors of difficult weaning are awake, ventilated with support settings and cooperative, they will be randomised to one of the two following study groups: intervention group (IMT and HFNC) and control group (IMT and Venturi mask). IMT will start as soon as possible. Each allocated oxygen delivery device will be applied immediately after extubation. IMT intervention will continue until patients' discharge from ICU. The primary outcome is the rate of weaning failure. Secondary outcomes are maximal inspiratory and expiratory strength, endurance of respiratory muscles, global muscle strength, functional ability and quality of life along with duration of ventilation (days) and ICU and hospital length of stay. CONCLUSION: The present study could significantly contribute to knowledge of how best to treat patients with difficult weaning and high risk of re-intubation. |
format | Online Article Text |
id | pubmed-7520168 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | European Respiratory Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-75201682020-10-01 The combination of inspiratory muscle training and high-flow nasal cannula oxygen therapy for promoting weaning outcomes in difficult-to-wean patients: protocol for a randomised controlled trial Patsaki, Irini Christakou, Anna Papadopoulos, Emmanouel Katartzi, Martha Kouvarakos, Alexandros Siempos, Ilias Tsimouris, Dimitris Skoura, Anastasia Xatzimina, Antonina Malachias, Sotirios Koulouris, Νikolaos Grammatopoulou, Eirini Zakinthinos, Spiros Ischaki, Eleni ERJ Open Res Study Protocols BACKGROUND: According to the literature, 20–30% of intubated patients are difficult to wean off mechanical ventilation and have a prolonged intensive care unit (ICU) stay with detrimental effects on muscle strength, functional ability and quality of life. Inspiratory muscle training (IMT) via a threshold device has been proposed as an effective exercise for minimising the effects of mechanical ventilation on respiratory muscles of critically ill patients with prolonged weaning. In addition, high-flow nasal cannula (HFNC) oxygen has been proved to provide efficient support for both high- and low-risk patients after extubation, thus preventing re-intubation. MATERIAL AND METHODS: A randomised controlled trial was designed to assess the efficacy of combining IMT and HFNC as therapeutic strategies for patients with high risk for weaning failure. Once patients with prognostic factors of difficult weaning are awake, ventilated with support settings and cooperative, they will be randomised to one of the two following study groups: intervention group (IMT and HFNC) and control group (IMT and Venturi mask). IMT will start as soon as possible. Each allocated oxygen delivery device will be applied immediately after extubation. IMT intervention will continue until patients' discharge from ICU. The primary outcome is the rate of weaning failure. Secondary outcomes are maximal inspiratory and expiratory strength, endurance of respiratory muscles, global muscle strength, functional ability and quality of life along with duration of ventilation (days) and ICU and hospital length of stay. CONCLUSION: The present study could significantly contribute to knowledge of how best to treat patients with difficult weaning and high risk of re-intubation. European Respiratory Society 2020-09-28 /pmc/articles/PMC7520168/ /pubmed/33015144 http://dx.doi.org/10.1183/23120541.00088-2020 Text en Copyright ©ERS 2020 http://creativecommons.org/licenses/by-nc/4.0/This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. |
spellingShingle | Study Protocols Patsaki, Irini Christakou, Anna Papadopoulos, Emmanouel Katartzi, Martha Kouvarakos, Alexandros Siempos, Ilias Tsimouris, Dimitris Skoura, Anastasia Xatzimina, Antonina Malachias, Sotirios Koulouris, Νikolaos Grammatopoulou, Eirini Zakinthinos, Spiros Ischaki, Eleni The combination of inspiratory muscle training and high-flow nasal cannula oxygen therapy for promoting weaning outcomes in difficult-to-wean patients: protocol for a randomised controlled trial |
title | The combination of inspiratory muscle training and high-flow nasal cannula oxygen therapy for promoting weaning outcomes in difficult-to-wean patients: protocol for a randomised controlled trial |
title_full | The combination of inspiratory muscle training and high-flow nasal cannula oxygen therapy for promoting weaning outcomes in difficult-to-wean patients: protocol for a randomised controlled trial |
title_fullStr | The combination of inspiratory muscle training and high-flow nasal cannula oxygen therapy for promoting weaning outcomes in difficult-to-wean patients: protocol for a randomised controlled trial |
title_full_unstemmed | The combination of inspiratory muscle training and high-flow nasal cannula oxygen therapy for promoting weaning outcomes in difficult-to-wean patients: protocol for a randomised controlled trial |
title_short | The combination of inspiratory muscle training and high-flow nasal cannula oxygen therapy for promoting weaning outcomes in difficult-to-wean patients: protocol for a randomised controlled trial |
title_sort | combination of inspiratory muscle training and high-flow nasal cannula oxygen therapy for promoting weaning outcomes in difficult-to-wean patients: protocol for a randomised controlled trial |
topic | Study Protocols |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7520168/ https://www.ncbi.nlm.nih.gov/pubmed/33015144 http://dx.doi.org/10.1183/23120541.00088-2020 |
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