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
| Autor: | Sotirios Malachias, Anna Christakou, Eirini Grammatopoulou, Dimitris Tsimouris, Ilias I. Siempos, Νikolaos Koulouris, Anastasia Skoura, Irini Patsaki, Emmanouel Papadopoulos, Eleni Ischaki, Martha Katartzi, Spiros Zakinthinos, Antonina Xatzimina, Alexandros Kouvarakos |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Mechanical ventilation Study Protocols business.industry medicine.medical_treatment lcsh:R lcsh:Medicine 030208 emergency & critical care medicine medicine.disease_cause law.invention 03 medical and health sciences 0302 clinical medicine 030228 respiratory system Randomized controlled trial law Anesthesia Oxygen therapy medicine Breathing Weaning Venturi mask Functional ability business Nasal cannula |
| Zdroj: | ERJ Open Research article-version (VoR) Version of Record ERJ Open Research, Vol 6, Iss 3 (2020) |
| ISSN: | 2312-0541 |
| Popis: | 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. This RCT will provide a therapeutic strategic plan for difficult-to-wean patients, minimising their intubation period and length of ICU stay https://bit.ly/37CkxTB |
| Databáze: | OpenAIRE |
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