Feasibility, safety, and patient acceptability of electronic inspiratory muscle training in patients who require prolonged mechanical ventilation in the intensive care unit: A dual-centre observational study.

Autor: Nickels M; Department of Physiotherapy, Ipswich Hospital, Brisbane, Australia; Discipline of Physiotherapy, University of Canberra, Australia., Erwin K; Physiotherapy Department, Canberra Hospital, Australia., McMurray G; Physiotherapy Department, Princess Alexandra Hospital, Brisbane, Australia., Talbot R; Discipline of Physiotherapy, University of Canberra, Australia., Strong M; Physiotherapy Department, Princess Alexandra Hospital, Brisbane, Australia., Krishnan A; Intensive Care Unit, Princess Alexandra Hospital, Brisbane, Australia., van Haren FMP; Intensive Care Unit, St George Hospital, Sydney, Australia; College of Health and Medicine, Australian National University, Canberra, Australia., Bissett B; Physiotherapy Department, Canberra Hospital, Australia; Discipline of Physiotherapy, University of Canberra, Australia. Electronic address: Bernie.Bissett@canberra.edu.au.
Jazyk: angličtina
Zdroj: Australian critical care : official journal of the Confederation of Australian Critical Care Nurses [Aust Crit Care] 2024 May; Vol. 37 (3), pp. 448-454. Date of Electronic Publication: 2023 Jun 14.
DOI: 10.1016/j.aucc.2023.04.008
Abstrakt: Background: Inspiratory muscle training (IMT) is an intervention that can be used to rehabilitate the respiratory muscle deconditioning experienced by patients with critical illness, requiring prolonged mechanical ventilation. Clinicians are currently using mechanical threshold IMT devices that have limited resistance ranges.
Objectives: The objective of this study was to evaluate the safety, feasibility, and acceptability of using an electronic device to facilitate IMT with participants requiring prolonged mechanical ventilation.
Method: A dual-centre observational cohort study, with convenience sampling, was conducted at two tertiary intensive care units. Daily training supervised by intensive care unit physiotherapists was completed with the electronic IMT device. A priori definitions for feasibility, safety, and acceptability were determined. Feasibility was defined as more than 80% of planned sessions completed. Safety was defined as no major adverse events and less than 3% minor adverse event rate, and acceptability was evaluated following the acceptability of intervention framework principles.
Results: Forty participants completed 197 electronic IMT treatment sessions. Electronic IMT was feasible, with 81% of planned sessions completed. There were 10% minor adverse events and no major adverse events. All the minor adverse events were transient without clinical consequences. All the participants who recalled completing electronic IMT sessions reported that the training was acceptable. Acceptability was demonstrated; over 85% of participants reported that electronic IMT was either helpful or beneficial and that electronic IMT assisted their recovery.
Conclusion: Electronic IMT is feasible and acceptable to complete with critically ill participants who require prolonged mechanical ventilation. As all minor adverse events were transient without clinical consequences, electronic IMT can be considered a relatively safe intervention with patients who require prolonged mechanical ventilation.
Competing Interests: Conflict of interest No conflicts to declare.
(Copyright © 2023 Australian College of Critical Care Nurses Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: