The comparison of the effectiveness of respiratory muscle exercises (RME) and incentive spirometry exercises (ISE) on improvement of lung function post mechanical ventilation: A literature review

2021 ◽  
Vol 31 ◽  
pp. S783-S787
Author(s):  
Herlina Masak Pasolang ◽  
Takdir Tahir ◽  
Siti Nurjannah
Keyword(s):  
Mechanical Ventilation ◽  
Lung Function ◽  
Literature Review ◽  
Respiratory Muscle ◽  
Incentive Spirometry

scholarly journals Ultrasonographic assessment of parasternal intercostal muscles during mechanical ventilation

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Paolo Formenti ◽  
Michele Umbrello ◽  
Martin Dres ◽  
Davide Chiumello
Keyword(s):  
Mechanical Ventilation ◽  
Ultrasound Imaging ◽  
Muscle Weakness ◽  
Respiratory Muscle ◽  
Muscle Activation ◽  
Invasive Mechanical Ventilation ◽  
Respiratory Muscles ◽  
Course Of Illness ◽  
Intercostal Muscles ◽  
Predictive Parameters

Abstract Although mechanical ventilation is a lifesaving treatment, abundant evidence indicates that its prolonged use (1 week or more) promotes respiratory muscle weakness due to both contractile dysfunction and atrophy. Along with the diaphragm, the intercostal muscles are one of the most important groups of respiratory muscles. In recent years, muscular ultrasound has become a useful bedside tool for the clinician to identify patients with respiratory muscle dysfunction related to critical illness and/or invasive mechanical ventilation. Images obtained over the course of illness can document changes in muscle dimension and can be used to estimate changes in function. Recent evidence suggests the clinical usefulness of ultrasound imaging in the assessment of intercostal muscle function. In this narrative review, we summarize the current literature on ultrasound imaging of the parasternal intercostal muscles as used to assess the extent of muscle activation and muscle weakness and its potential impact during discontinuation of mechanical ventilation. In addition, we proposed a practical flowchart based on recent evidence and experience of our group that can be applied during the weaning phase. This approach integrates multiple predictive parameters of weaning success with respiratory muscle ultrasound.

High oxygen concentrations predispose mouse lungsto the deleterious effects of high stretch ventilation

2003 ◽  
Vol 94 (3) ◽  
pp. 975-982 ◽  
Author(s):  
Timothy C. Bailey ◽  
Erica L. Martin ◽  
Lin Zhao ◽  
Ruud A. W. Veldhuizen
Keyword(s):  
Mechanical Ventilation ◽  
Acute Lung Injury ◽  
Lung Function ◽  
Lung Injury ◽  
Inflammatory Cytokines ◽  
Pulmonary Surfactant ◽  
Ex Vivo ◽  
Lung Stretch ◽  
Isolated Lungs ◽  
Mechanical Ventilation Group

Mechanical ventilation is a necessary intervention for patients with acute lung injury. However, mechanical ventilation can propagate acute lung injury and increase systemic inflammation. The exposure to >21% oxygen is often associated with mechanical ventilation yet has not been examined within the context of lung stretch. We hypothesized that mice exposed to >90% oxygen will be more susceptible to the deleterious effects of high stretch mechanical ventilation. C57B1/6 mice were randomized into 48-h exposure of 21 or >90% oxygen; mice were then killed, and isolated lungs were randomized into a nonstretch or an ex vivo, high-stretch mechanical ventilation group. Lungs were assessed for compliance and lavaged for surfactant analysis, and cytokine measurements or lungs were homogenized for surfactant-associated protein analysis. Mice exposed to >90% oxygen + stretch had significantly lower compliance, altered pulmonary surfactant, and increased inflammatory cytokines compared with all other groups. Our conclusion is that 48 h of >90% oxygen and high-stretch mechanical ventilation deleteriously affect lung function to a greater degree than stretch alone.

Optimization of Respiratory Muscle Relaxation during Mechanical Ventilation

1988 ◽  
Vol 69 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Michael E. Ward ◽  
Claude Corbeil ◽  
William Gibbons ◽  
Stephen Newman ◽  
Peter T. Macklem
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Muscle ◽  
Muscle Relaxation

scholarly journals Técnicas respiratórias na melhora da função pulmonar de cardiopatas: Uma Revisão Integrativa

2021 ◽  
Vol 12 (3) ◽  
pp. 26-32
Author(s):  
Danyele Holanda da Silva ◽  
Tassiane Maria Alves Pereira ◽  
Janaína De Moraes Silva
Keyword(s):  
Cardiac Surgery ◽  
Lung Function ◽  
Surgical Procedure ◽  
Respiratory Muscle ◽  
Lung Compliance ◽  
Integrative Review ◽  
World Health ◽  
Respiratory Muscle Training ◽  
Breathing Exercises ◽  
Cardiac Surgical Procedure

Introduction: Cardiovascular Diseases (CVD) are the main cause of morbidity and mortality in developed and developing countries. According to World Health Organization estimates, 17.9 million people died of CVD in 2016, representing 31% of all global deaths. Material and Method: Integrative review carried out in the databases PubMed, SciELO, Lilacs and PEDro, based on the guiding question of the search: “what is the effect of respiratory techniques on the lung function of patients undergoing cardiac surgery?”, And crossing of the terms: breathing exercises AND preoperative AND cardiac surgery (all terms present in MEsh and DeCs) from May to June 2020. Results: 104 articles were found in the selected databases, 67 articles were excluded, 37 were selected for full reading, eight of which were part of this review. Discussion: The present integrative review aimed to analyze the effects of respiratory techniques on lung function in patients undergoing cardiac surgery. Patients undergoing a cardiac surgical procedure, mainly develop postoperative pulmonary dysfunction with significant reduction in lung volumes, impaired respiratory function, decreased lung compliance and increased respiratory work. Final Considerations: Respiratory techniques such as breathing exercises and / or respiratory muscle training employed in patients undergoing a cardiac surgical procedure, improve lung function, consequently improving respiratory muscle strength as a whole, also interfering in the reduction of post-respiratory complications. CRM in this population.Keywords: Cardiac surgery; Breathing Exercises; Preoperative.

scholarly journals Respiratory Muscle Effort during Expiration in Successful and Failed Weaning from Mechanical Ventilation

2018 ◽  
Vol 129 (3) ◽  
pp. 490-501 ◽  
Author(s):  
Jonne Doorduin ◽  
Lisanne H. Roesthuis ◽  
Diana Jansen ◽  
Johannes G. van der Hoeven ◽  
Hieronymus W. H. van Hees ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Electrical Activity ◽  
Muscle Activity ◽  
Respiratory Muscle ◽  
Weaning From Mechanical Ventilation ◽  
Expiratory Muscle ◽  
Diaphragm Electrical Activity ◽  
Gastric Pressure ◽  
Weaning Failure ◽  
Expiratory Muscles

Abstract What We Already Know about This Topic What This Article Tells Us That Is New Background Respiratory muscle weakness in critically ill patients is associated with difficulty in weaning from mechanical ventilation. Previous studies have mainly focused on inspiratory muscle activity during weaning; expiratory muscle activity is less well understood. The current study describes expiratory muscle activity during weaning, including tonic diaphragm activity. The authors hypothesized that expiratory muscle effort is greater in patients who fail to wean compared to those who wean successfully. Methods Twenty adult patients receiving mechanical ventilation (more than 72 h) performed a spontaneous breathing trial. Tidal volume, transdiaphragmatic pressure, diaphragm electrical activity, and diaphragm neuromechanical efficiency were calculated on a breath-by-breath basis. Inspiratory (and expiratory) muscle efforts were calculated as the inspiratory esophageal (and expiratory gastric) pressure–time products, respectively. Results Nine patients failed weaning. The contribution of the expiratory muscles to total respiratory muscle effort increased in the “failure” group from 13 ± 9% at onset to 24 ± 10% at the end of the breathing trial (P = 0.047); there was no increase in the “success” group. Diaphragm electrical activity (expressed as the percentage of inspiratory peak) was low at end expiration (failure, 3 ± 2%; success, 4 ± 6%) and equal between groups during the entire expiratory phase (P = 0.407). Diaphragm neuromechanical efficiency was lower in the failure versus success groups (0.38 ± 0.16 vs. 0.71 ± 0.36 cm H2O/μV; P = 0.054). Conclusions Weaning failure (vs. success) is associated with increased effort of the expiratory muscles and impaired neuromechanical efficiency of the diaphragm but no difference in tonic activity of the diaphragm.

Patients’ perspective and lung function correlation:the importance of questionnaires in home mechanical ventilation

2021 ◽  
Author(s):  
Ana Da Cunha Fonseca ◽  
Marta Sá Marques ◽  
Sara Conde ◽  
Pedro Oliveira ◽  
Carla Nogueira ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Lung Function ◽  
Home Mechanical Ventilation ◽  
Patients Perspective

scholarly journals Different outcomes of pulmonary rehabilitation in patients with COPD with or without exacerbations

2005 ◽  
Vol 63 (3) ◽  
Author(s):  
G.G. Riario-Sforza ◽  
C. Incorvaia ◽  
F. Paterniti ◽  
N. Dugnani ◽  
M. Fumagalli
Keyword(s):  
Lung Function ◽  
Physical Performance ◽  
Pulmonary Rehabilitation ◽  
Respiratory Muscle ◽  
Hospital Setting ◽  
Favourable Outcome ◽  
Respiratory Muscle Training ◽  
Copd Exacerbations ◽  
Group A ◽  
Group B

Background. Pulmonary rehabilitation is recognised as an effective treatment in reducing disability and improving the quality of life in patients with COPD. We evaluated the effects of a course of pulmonary rehabilitation in improving the physical performance and lung function in patients with or without COPD exacerbations. Methods. 74 patients with COPD were enrolled, 37 (24 males and 13 females, mean age 74.6 years) without exacerbations (group A), and 37 (23 males, 14 females, mean age 73.9 years) with exacerbations (group B). The latter must have had the latest exacerbation at least one month before the inclusion. All patients underwent to a rehabilitation programme of 8 visits in 4 weeks in a day-hospital setting, with exercise training, respiratory muscle training and education on COPD. The changes in physical performance and lung function in respect to baseline were measured by a 6-minute walking test, using phethysmography, and by an analogic manometer measuring maximal inspiratory and expiratory pressures (MIP, MEP). Results. Patients of group A showed a mean increase in timed walk distance of 58.38 ± 57.46 m, compared to a mean increase of 31.38 ± 44.78 m in group B patients (p = 0.028). As to lung function, a mean increase of 178.92 ± 132.28 ml in FEV1 in group A versus 67.84 ± 102.04 ml in group B (p < 0.0001) and a mean increase of 22.36 ± 25.06 cm H2O in MEP in group A versus 7.70 ± 12.28 cm H2O in group B (p = 0.002) was found. Conclusions. These findings indicate that patients with COPD with exacerbations achieve a less favourable outcome of pulmonary rehabilitation, with a significantly lower improvement of physical performance, respiratory muscle strength and lung function in respect to subjects without exacerbations.

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