scholarly journals Early effects of inspiratory muscle training in critical patients submitted to mechanical ventilation: A study protocol for a randomised controlled trial

2021 ◽  
Author(s):  
Franciele Borges de Oliveira ◽  
Fabrício Olinda de Souza Mesquita ◽  
Jéssica Mascena de Medeiros ◽  
Hálisson Alves Ribeiro ◽  
Paula Tamara Fonseca de Oliveira ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Randomised Controlled Trial ◽  
Muscle Strength ◽  
Respiratory Muscle ◽  
Controlled Trial ◽  
Respiratory Muscle Strength ◽  
Muscle Training ◽  
Randomised Controlled

Abstract Background: Respiratory muscle weakness is one of the primary factors associated with difficulty of ventilatory weaning in critically ill patients. In this sense, inspiratory muscle training (IMT) is a possible facilitator of successful weaning. One of the devices used for IMT is the POWERbreathe®, because it provides a linear pressure load, with the possibility of gradual increments. The effectiveness of early IMT in this population is not yet well known. The aim of this study is to assess the effects of early IMT with a mechanical loading device on the weaning time of patients on invasive mechanical ventilation (primary outcome), respiratory muscle strength, length of stay in the intensive care unit and in the success rate of weaning (secondary outcomes).Methods: This randomised controlled trial, a single blind evaluation, will be conducted in the intensive care unit of a university hospital on 42 adults, who will be randomly and blindly categorised into the control group, comprising patients who undergo routine physical therapy only, and the training group, comprising patients who undergo routine physical therapy associated with IMT twice a day, with load adjusted daily at 50% of maximum inspiratory pressure, three series of 10 repetitions with one minute rest in between. Both groups will be assessed when patients are eligible for the study and before the ventilatory support withdrawal. Effects of the training will be analysed from the collected data using intention-to-treat analysis. Between-group differences will be measured using generalised estimating equations for data analysis.Discussion: Results of this trial will likely provide valuable new information on the effects of IMT on weaning time, respiratory muscle strength, length of stay in the intensive care unit and the success rate of weaning in critically ill patients.Registration: ClinicalTrials.gov, NCT03758573. 29th November 2018.

scholarly journals Early effects of inspiratory muscle training in critical patients submitted to mechanical ventilation: A study protocol for a randomised controlled trial

2021 ◽  
Author(s):  
Franciele Borges de Oliveira ◽  
Fabrício Olinda de Souza Mesquita ◽  
Jéssica Mascena de Medeiros ◽  
Hálisson Alves Ribeiro ◽  
Paula Tamara Fonseca de Oliveira ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Randomised Controlled Trial ◽  
Muscle Strength ◽  
Respiratory Muscle ◽  
Controlled Trial ◽  
Respiratory Muscle Strength ◽  
Muscle Training ◽  
Randomised Controlled

Abstract Background: Respiratory muscle weakness is one of the primary factors associated with difficulty of ventilatory weaning in critically ill patients. In this sense, inspiratory muscle training (IMT) is a possible facilitator of successful weaning. One of the devices used for IMT is the POWERbreathe®, because it provides a linear pressure load, with the possibility of gradual increments. The effectiveness of early IMT in this population is not yet well known. The aim of this study is to assess the effects of early IMT with a mechanical loading device on the weaning time of patients on invasive mechanical ventilation (primary outcome), respiratory muscle strength, length of stay in the intensive care unit and in the success rate of weaning (secondary outcomes).Methods: This randomised controlled trial, a single blind evaluation, will be conducted in the intensive care unit of a university hospital on 42 adults, who will be randomly and blindly categorised into the control group, comprising patients who undergo routine physical therapy only, and the training group, comprising patients who undergo routine physical therapy associated with IMT twice a day, with load adjusted daily at 50% of maximum inspiratory pressure, three series of 10 repetitions with one minute rest in between. Both groups will be assessed when patients are eligible for the study and before the ventilatory support withdrawal. Effects of the training will be analysed from the collected data using intention-to-treat analysis. Between-group differences will be measured using generalised estimating equations for data analysis.Discussion: Results of this trial will likely provide valuable new information on the effects of IMT on weaning time, respiratory muscle strength, length of stay in the intensive care unit and the success rate of weaning in critically ill patients.Registration: ClinicalTrials.gov, NCT03758573. 29th November 2018.

scholarly journals SuDDICU Protocol

2021 ◽  
Author(s):  
Laurent Billot ◽  
Brian Cuthbertson ◽  
Simon Finfer ◽  
Fiona Goodman ◽  
Anthony Gordon ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Randomised Controlled Trial ◽  
Digestive Tract ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Selective Decontamination ◽  
Cluster Randomised ◽  
Randomised Controlled

Protocol for a crossover, cluster randomised controlled trial of Selective Decontamination of the Digestive Tract in Intensive Care Unit patients.

scholarly journals Chewing gum prophylaxis for postoperative nausea and vomiting in the intensive care unit: a pilot randomised controlled trial

2020 ◽  
Vol 22 (4) ◽  
pp. 321-326
Author(s):  
Hussam Abdelkarim ◽  
◽  
Natasha Ciampoli ◽  
Lara Zwakman-Hessels ◽  
Jai N Darvall ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Randomised Controlled Trial ◽  
Postoperative Nausea ◽  
Controlled Trial ◽  
Postoperative Nausea And Vomiting ◽  
Chewing Gum ◽  
Pilot Randomised Controlled Trial ◽  
Surgical Icu ◽  
Randomised Controlled

Objective: To test the effectiveness of chewing gum in the prophylaxis of postoperative nausea and vomiting (PONV) in patients admitted to the intensive care unit (ICU) after surgery. Design: Prospective, open label, pilot randomised controlled trial. Setting: Two metropolitan ICUs. Participants: Ninety postoperative adult patients admitted to the ICU. Intervention: Patients administered chewing gum, who chewed for at least 15 minutes every 4 hours, were compared with a control group, who were administered a 20 mL sip of water orally every 4 hours. Main outcome measures: The primary outcome was the number of patient-reported episodes of nausea in the first 24 hours after the operation. Secondary outcomes included vomiting or dry retching episodes, and duration and severity of nausea. Results: Forty-six patients were randomly allocated to chewing gum and 44 patients to water. There was no difference between groups in the number of patients with nausea (10 [22%] chewing gum v 12 [27%] control patients; P = 0.72), nausea episodes (22 episodes; [median, 0; IQR, 0–0] v 21 episodes [median, 0; IQR, 0–1] per patient in each group respectively), vomiting/retching (2 [4%] chewing gum v 6 [14%] control patients; P = 0.24), or duration/severity of nausea. Conclusion: Regular postoperative administration of chewing gum in a surgical ICU patient cohort did not reduce nausea, vomiting or retching. The prevalence of PONV is less than previously reported. Our findings can inform future studies of PONV prophylaxis in post-surgical ICU patients. Trial registration: Australian New Zealand Clinical Trial Registry No. ACTRN12617001185358.

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