INSPIRATORY MUSCULATURE TRAINING WITH THRESHOLD DEVICE ON RESPIRATORY MUSCLE DYSFUNCTION IN ICU ASSOCIATED WITH MECHANICAL VENTILATION. A DOCUMENTARY REVIEW

J.S. Moreno Parra¹, L.C. Espejo Salamanca¹, W.A. Villamil Parra², F. Moscoso Alvarado²

Background: Respiratory rehabilitation has acquired an important role in the management of critically ill persons in intensive care units. Strategies such as mechanical ventilation, pharmacological muscle relaxation, even the overuse of corticosteroid drugs, generate a functional alteration of the neuromotor plaque causing a noticeable alteration of muscle performance in the respiratory muscles. It is here that the physiotherapist through professional and evidence-based reasoning, must use therapeutic techniques and strategies that allow to give the user the maximum functional capacity of the person.

Purpose: The aim of this study is to identify the effects of Inspiratory Muscle Training with a Threshold resistance device on the respiratory muscle dysfunction in ICU associated with Mechanical Ventilation.

Methods: Descriptive study of the documentary and bibliographic review type of scientific articles such as randomized controlled clinical trials, cases and controls and prospective pilot studies. Articles were selected with people, men and women, over 18 years, who were in the Intensive Care Unit with a requirement for ventilatory support and in which Inspiratory Muscle Training was used through the Threshold IMT device.

Results: A total of 15 articles (n = 15) were selected for analysis after going through the selection process under inclusion and exclusion criteria. In 12 of the 15 selected articles, it was identified that inspiratory muscle training through the Threshold device has significant effects on different variables that are involved in respiratory muscle work and altered and involved variables in the ICU setting, such as MIP (p <0.05), ventilatory weaning and extubating time. A trend was found in the results to an intervention from 10 to 14 days, frequency twice a day for 7 days a week, with a volume of 5 sets of 6 repetitions. Loading 30% of initial MIP with a daily increase in device resistance of 1-2 cm H₂O or 10% of initial MIP.

Conclusion(s): Respiratory muscle training, together with a joint work with other kinetic modalities used in the clinical environment, brings significantly positive effects on variables that helps directly on ventilatory weaning by decreasing the muscle respiratory dysfunction, in order to reducing the time, it is carried out successfully.

Implications: Give the professional certainty that the use of this type of training, and under certain previously established protocols under certain protocols previously established and evaluated globally, generate less economic burdens on the health system, improving the different services, under a concept of cost-benefit in the institution-person relationship. In addition, increasing the quality of life of people by decreasing comorbidities associated with prolonged stay in-hospital settings.

Funding, acknowledgements: None declared by the authors

Keywords: Intensive Care Units, Breathing Exercises, Ventilator Weaning

Topic: Critical care

Did this work require ethics approval? No

Institution: N/A

Committee: N/A

Reason: Because it's a docummentary review. It did'nt require intervention