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. 2019 Jan;30(1):44-50.
doi: 10.1097/CPT.0000000000000092.

Inspiratory Muscle Training in Patients with Prolonged Mechanical Ventilation: Narrative Review

Shakeel Ahmed  1 , A Daniel Martin  1 , Barbara K Smith  1   2
Affiliations

Inspiratory Muscle Training in Patients with Prolonged Mechanical Ventilation: Narrative Review

Shakeel Ahmed et al. Cardiopulm Phys Ther J. 2019 Jan.

Abstract

Patients with impending respiratory failure often require mechanical ventilation to optimize gas exchange. Although this form of assisted ventilation is required for survival, its persistent use results in diaphragm weakness and muscle fiber atrophy. There is strong evidence that mechanical ventilation alters the structure and function of the diaphragm, resulting in prolonged dependence on assisted ventilation and long-term consequences such as a delayed functional recovery, reduced quality of life and increased risk of mortality. This review summarizes the mechanisms underlying diaphragm dysfunction due to prolonged mechanical ventilation, highlights the role of inspiratory muscle exercise as a strategy to counter diaphragm weakness, and identifies the parameters of an evidence-supported exercise prescription for difficult to wean patients.

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Conflict of interest statement

Notification of Conflicts of Interest: ADM is an external consultant for Lungpacer, which is developing an intravenous phrenic nerve pacing system.

Figures

Figure 1:
Figure 1:
Potential mechanisms of VIDD
See this image and copyright information in PMC

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