Respiratory Muscle Rehabilitation in Patients with Prolonged Mechanical Ventilation: A Targeted Approach

Abstract

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2020. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2020. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.

Fig. 1

Handheld respiratory pressure manometer connected to endotracheal tube for measurement of maximal inspiratory pressure (Reproduced from [14] with permission)

Fig. 2

Attachment of electronic inspiratory muscle training device to filter and connector

Fig. 3

A single respiratory cycle, comparing mechanical threshold loading (MTL) with tapered flow resistive loading (TFRL) in a ventilator-dependent patient. Pmouth pressure at the mouth, WOB work of breathing

Fig. 4

Tapered flow resistive loading inspiratory muscle training in a ventilator-dependent patient (upper panel). Visual feedback provided during tapered flow resistive loading in a ventilator-dependent patient (lower panel)

Fig. 5

Criteria for suitability for inspiratory muscle training for ICU patients. PEEP positive end-expiratory pressure, FiO₂ fraction of inspired oxygen, RR respiratory rate, MIP maximum inspiratory pressure, NIF negative inspiratory force (measured on the ventilator). *Recently weaned means independently breathing 24 hours per day without any invasive ventilatory support. (Reproduced from [14] with permission)