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Treinamento muscular respiratorio em pacientes em desmame da ventilacao mecanica (Respiratory muscle training in patients weaning from mechanical ventilation) [Portuguese]
Pascotini FS, Denardi C, Nunes GO, Trevisan ME, Antunes VP
ABCS Health Sciences 2014;39(1):12-16
clinical trial
3/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

INTRODUCTION: The weakness of the respiratory muscles is a major cause of difficulty and/or failure of weaning. To minimize the effects of prolonged mechanical ventilation (MV), the physiotherapists use respiratory muscle training, being the threshold IMT the most commonly used method. OBJECTIVE: To evaluate the effectiveness of respiratory muscle training using the threshold IMT device on respiratory parameters in patients weaning from MV. METHODS: Patients were distributed randomly in the control group and the experimental group (GI and GII). On the first day of the weaning, the respiratory muscle strength (PImax/PEmax), tidal volume (TV), respiratory rate (RR) and heart rate (HR) were evaluated. For seven days, the GI received three sessions of conventional physiotherapy and GII has additionally held respiratory muscle training (RMT) with the threshold IMT, once a day, in the afternoon, connected to tracheostomy, and three sets of ten repetitions, at a load of 20% of PImax. The data were statistically treated by adopting a significance level alpha = 0.05. RESULTS: There was an increase (p = 0.02) in RR and a decrease in the PImax (p = 0.04) in GI, demonstrating increased work of breathing and loss of muscle strength between the first and the seventh day of weaning. In GII, the variables did not change significantly, observing the maintenance of respiratory function. CONCLUSION: Thus, RMT is beneficial, ensuring the maintenance of respiratory parameters, which can be an ally in weaning.

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