Use of the inspiratory muscle trainer device( IMT) after exubation in a critical care setting

Abstract

Background: Mechanical ventilation (MV) and intensive care unit (ICU) admission are necessary medical interventions when required. However the effects of bed rest and immobility result in dysfunctions that occur within a very short period of time (Winkelman, 2007). The resultant diaphragmatic weakness results in weaning and extubation failure and may result in the need for re-intubation (Martin et al., 2013; Thille et al., 2013). In mechanically ventilated patients, inspiratory muscle training (IMT) has been administered to decrease weaning failure by increasing diaphragmatic strength (Cader et al., 2010).The use of IMT during prolonged MV reportedly improved the perception of dyspnoea, six minute walk test (6MWT) and the ability to perform activities of daily living (ADL) and the resultant quality of life (QOL) in some survivors of critical illness (Chang et al., 2005). The aim of this study was to establish the effect of the addition of IMT to standard in-hospital physiotherapy treatment on re-intubation rate and other outcomes of patients who were extubated after prolonged MV.