• da Silva GuimarãesBrunoBMedical Science Post-graduation Program, Universidade Federal Fluminense, Rio de Janiero, Brazil.Physical Therapy Hospital Naval Marcilio Dias, Rio de Janiero, Brazil (Brazil's Navy)., Leonardo Cordeiro de Souza, Hebe Faria Cordeiro, Thiago Loureiro Regis, Cristiane Almeida Leite, Fernanda Patricio Puga, Sergio Hernando Alvim, and Jocemir Ronaldo Lugon.
• Medical Science Post-graduation Program, Universidade Federal Fluminense, Rio de Janiero, Brazil.
• Crit. Care Med. 2021 Apr 1; 49 (4): 589597589-597.

ObjectivesTo test if the use of an inspiratory muscle training program with an electronic resistive loading device is associated with benefits as to muscle strength, weaning, and survival in the ICU.DesignProspective randomized controlled trial.SettingsStudy conducted at the ICU of a Navy's hospital, Rio de Janeiro, Brazil, from January 2016 to September 2018.PatientsTracheostomized patients (18-86 yr) on prolonged weaning.InterventionsParticipants were assigned to inspiratory muscle training (intervention group) or a traditional T-piece protocol (control group). In the inspiratory muscle training group, participants underwent training with an electronic inspiratory training device (POWERbreathe K-5; Technologies Ltd, Birmingham, United Kingdom).Measurements And Main ResultsChanges in respiratory muscle strength and rates of ICU survival and weaning success were compared between groups. Forty-eight participants in the inspiratory muscle training group and 53 ones in the control group were included in the final analysis. The inspiratory muscle training was associated with a substantially higher gain on muscle strength as assessed by the maximal inspiratory pressure (70.5 [51.0-82.5] vs -48.0 cm H2O [36.0-72.0 cm H2O]; p = 0.003) and the timed inspiratory effort index (1.56 [1.25-2.08] vs 0.99 cm H2O/s [0.65-1.71 cm H2O/s]; p = 0.001). Outcomes at the 60th day of ICU were significantly better in the intervention group regarding both survival (71.1% vs 48.9%; p = 0.030) and weaning success (74.8% vs 44.5%; p = 0.001).ConclusionsThe use of an inspiratory muscle training program with an electronic resistive loading device was associated with substantial muscle strength gain and positive impacts in two very relevant clinical outcomes: the rates of ICU survival and successful weaning.Copyright © 2020 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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