Dados do Resumo

Título

Elaboration of an inspiratory muscle training protocol for adult cancer patients weaning from invasive mechanical ventilation

Introdução

The transition from artificial ventilation to spontaneous ventilation is called ventilatory weaning. Failures in the process increase hospital admission rates, decline in functional status, and mortality. The etiology of failure is complex, but inspiratory muscle weakness can play an important role in delaying the process, and inspiratory muscle training (IMT) is used as a great ally in effective weaning. There are no studies using IMT in ventilatory weaning in the oncology population.

Objetivo

To develop an inspiratory muscle training protocol for adult cancer patients weaning from invasive mechanical ventilation.

Métodos

A literature review was conducted with the following PICOt question: "Does inspiratory muscle training facilitate the invasive ventilatory weaning process?", the search was carried out from April to June 2024, in the Pubmed, PEDro, Scielo, EMBASE, and LILACS databases using the Medical Subject Headings (MESHS): "Ventilator Weaning", "Breathing Exercises", "Endurance Training", "Resistance Training", studies without language restrictions, randomized clinical trials, systematic reviews, and guidelines were included, and studies that did not address the theme, published more than 10 years ago, case studies, and studies without data on periodization and progression of IMT were excluded. The present study was prepared according to the SPIRIT methodology.

Resultados

A total of 296 potentially eligible articles were found. 26 were fully analyzed. At the end of the evaluation, 7 studies were included. IMT is an important resource for strengthening inspiratory muscles and facilitating weaning from mechanical ventilation, its benefits go beyond reducing hospital admission. The initiation of therapy will depend on criteria of neurological, cardiovascular and respiratory stability. The prescription will be in accordance with the results obtained in the manovacuometry and the patient should be encouraged to perform it with a resistive loading and conical flow device (PowerBreathe), with 50% of the maximum inspiratory pressure obtained in manovacuometry, when more than 7 days of invasive mechanical ventilation at least twice a day, six sets of six breaths, always observing the signs of intolerance and aiming for progression of load, volume and intensity daily according to the therapist's assessment.

Conclusões

We created an IMT protocol for critically ill cancer patients, emphasizing the objectives of the technique, the promising results described and the ways to carry it out with regard to eligibility criteria, safety, periodization, progression and signs of intolerance, according to a survey in the literature. We believe that its implementation is essential to facilitate weaning from invasive mechanical ventilation.

Financiador do resumo

None.

Palavras Chave

Ventilator Weaning; Breathing Exercises; Resistance Training