Treinamento Muscular Inspiratório No Ambiente Hospitalar: Protocolo Para Um Ensaio Clínico Randomizado

Júnior, Balbino Rivail Ventura Nepomuceno; Gomes‐Neto, Mansueto

doi:10.17267/2238-2704rpf.v6i2.896

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…Our patients improved respiratory muscle strength and endurance (expressed by MIP and SMIP and FRI, respectively). This may be due to respiratory muscle training (RMT), an important respiratory muscle reconditioning strategy that positively impacts respiratory muscle strength and endurance (20) and correlates with PEF (21,22). It is important to highlight that RMT and aerobic and endurance training probably favored these gains.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a rehabilitation protocol on pulmonary and respiratory muscle function and ultrasound evaluation of diaphragm and quadriceps femoris in patients with post-COVID-19 syndrome: a series of cases

Costa

Souza

Felix

et al. 2022

Monaldi Arch Chest Dis

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This study assessed the efficacy of a pulmonary rehabilitation (PR) on pulmonary and respiratory muscle function and thickness of quadriceps femoris and diaphragm of patients with post-COVID-19 syndrome. This series of cases followed nine patients who performed PR twice a week for six weeks. Patients received the following PR program: lung expansion therapy; respiratory muscle training; upper limb strength exercises; aerobic exercises on a treadmill. After the program, we observed increased peak expiratory flow (26.03%), forced vital capacity (FVC) (7.14%), forced expiratory volume in the first second (FEV1) (9.55%), and ratio between FEV1/FVC (6.19%). All parameters of respiratory muscle strength and endurance were improved. Diaphragmatic thickening fraction and thickness of quadriceps femoris also improved, whereas echo intensity of quadriceps reduced. Thus, RP protocol improved pulmonary function, respiratory muscle strength and endurance, and thickness of diaphragm and quadriceps femoris, and reduced echo intensity of quadriceps in patients with post-COVID-19 syndrome.

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Section: Discussionmentioning

confidence: 99%

Efficacy of a rehabilitation protocol on pulmonary and respiratory muscle function and ultrasound evaluation of diaphragm and quadriceps femoris in patients with post-COVID-19 syndrome: a series of cases

Costa

Souza

Felix

et al. 2022

Monaldi Arch Chest Dis

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Safety and efficacy of inspiratory muscle training for preventing adverse outcomes in patients at risk of prolonged hospitalisation

Nepomuceno

Barreto²,

Almeida³

et al. 2017

Trials

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BackgroundThe early institution of inspiratory muscle training on hospitalised patients with no established respiratory deficits could prevent in-hospital adverse outcomes that are directly or indirectly associated to the loss of respiratory muscle mass inherent to a prolonged hospital stay. The objective of the clinical trial is to assess the impact of inspiratory muscle training on hospital inpatient complications.MethodsThis is a double-blind randomised controlled trial. Subjects in the intervention group underwent an inspiratory muscle training loaded with 50% maximum inspiratory pressure twice daily for 4 weeks from study enrolment. Patients were randomly assigned to an inspiratory muscle training group or a sham inspiratory muscle training group. All patients received conventional physiotherapy interventions. Baseline and post-intervention respiratory and peripheral muscle strength, functionality (performance of activities of daily living), length of hospital stay, and death were evaluated. Clinical outcomes were assessed until hospital discharge. This study was approved by the Institutional Hospital Ethics Committee (03/2014).ResultsThirty-one patients assigned to the inspiratory muscle training group and 34 to the sham inspiratory muscle training group were analysed. Patients in the inspiratory muscle training group had a shorter mean length of hospital stay (35.3 ± 2.7 vs. 41.8 ± 3.5 days, p < 0.01) and a lower risk of endotracheal intubation (relative risk (RR) = 0.36; 95% confidence interval (CI) 0.27–0.97; p = 0.03) as well as muscle weakness (RR = 0.36; 95% CI 0.19–0.98; p = 0.02) and mortality (RR = 0.23; 95% CI 0.2–0.94; p = 0.04). The risk of adverse events did not differ significantly between groups.ConclusionInspiratory muscle training was a protective factor against endotracheal intubation, muscle weakness, and mortality.Trial registrationClinicalTrials.gov, ID: NCT02459444. Registered on 19 May 2015.

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Manovacuometria Como Preditor No Sucesso Da Extubação

Tavares,

Santana,

Da Silva

et al. 2023

Rev. Foco

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INTRODUÇÃO: Na Unidade de terapia intensiva (UTI) são submetidos pacientes em estado grave ou de risco, potencialmente recuperáveis, que exigem assistência ininterrupta. A ventilação mecânica (VM) invasiva é um dos pilares terapêuticos para tratamento de pacientes graves, em especial, os que apresentam insuficiência respiratória. A mensuração da força muscular respiratória é realizada com o uso de um manovacuômetro, este equipamento é apropriado para medir pressões positivas (manômetro) e pressões negativas (vacuômetro), consequentemente mensurando a força muscular inspiratória (PImáx) e expiratória (PEmáx). Em uma visão geral, a PImáx acima de 60 cmH2O podem ser considerados normais, valores entre 40 e 60 cmH2O podem indicar normalidade, a não ser que haja fraqueza visível de outros músculos e valores inferiores a 40 cmH2O indicam fadiga ou fraqueza muscular respiratório. METODOLOGIA: Trata-se de uma revisão bibliográfica sistemática, realizada através de levantamento bibliográfico relacionado ao tema Manovacuometria como Preditor no Sucesso da Extubação. Os critérios de inclusão foram: artigos publicados a partir do ano 2010, teses, dissertações na língua portuguesa e estrangeira. RESULTADOS: Para dar início à pesquisa, buscou-se artigos nas bases de dados com os descritores mencionados, totalizando 72 publicações científicas que, a partir da leitura do título restaram 29, sendo os mesmos utilizados somente uma vez na base de dados que primeiro referenciou o artigo como critério para seleção. Realizada leitura dos resumos, restaram 18 os quais, compõem essa revisão integrativa.DISCUSSOES: Os índices de Desmame da Ventilação Mecânica podem ser usados em populações homogêneas, embora a acurácia possa ser menor nessas do que em populações heterogêneas. A avaliação da PImáx e PEmáx como índice preditor de sucesso no desmame da ventilação mecânica é um procedimento rotineiramente realizado. CONSIDERAÇÕES FINAIS: Foi possível observar nesse estudo que o uso da manovacuometria é eficaz para avaliar a força da musculatura respiratória através da PImáx e PEmáx de cada paciente, assim promovendo um aumento das taxas de sucesso das extubações. O processo de extubação sem uma avaliação eficaz pode gerar aumento de: reitubação, tempo de permanência na ventilação mecânica, taxa de mortalidade, dias de internações e gerando consequentemente um aumento de gastos hospitalares.

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Treinamento Muscular Inspiratório No Ambiente Hospitalar: Protocolo Para Um Ensaio Clínico Randomizado

Cited by 3 publications

References 22 publications

Efficacy of a rehabilitation protocol on pulmonary and respiratory muscle function and ultrasound evaluation of diaphragm and quadriceps femoris in patients with post-COVID-19 syndrome: a series of cases

Efficacy of a rehabilitation protocol on pulmonary and respiratory muscle function and ultrasound evaluation of diaphragm and quadriceps femoris in patients with post-COVID-19 syndrome: a series of cases

Safety and efficacy of inspiratory muscle training for preventing adverse outcomes in patients at risk of prolonged hospitalisation

Manovacuometria Como Preditor No Sucesso Da Extubação

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