• Lígia Dos Santos Roceto Ratti, Marques TonellaRodrigoRPhysiotherapy Department, School of Physical Education, Physiotherapy and Occupational Therapy (EEFFTO), Federal University of Minas Gerais, Belo Horizonte, Brazil., Luciana Castilho de Figueir do, Bredda SaadIvete AlonsoIAPhysiotherapy and Occupational Therapy Service, University Hospital (HC Unicamp), Campinas State University, Campinas, São Paulo, Brazil., Eiras FalcãoAntonio LuisALDepartment of Surgery, Intensive Care Unit, Neurosurgery, University Hospital (HC Unicamp), Campinas State University, Campinas, São Paulo, Brazil., and Martins de OliveiraPedro PauloPPDepartment of Surgery, Intensive Care Unit, Cardiothoracic Surgery, University Hospital (HC Unicamp), Campinas State University, Campinas, São Paulo, Brazil..
• Physiotherapy and Occupational Therapy Service, University Hospital (HC Unicamp), Campinas State University, Campinas, São Paulo, Brazil. ligiasro@unicamp.br.
• Respir Care. 2022 Aug 1; 67 (8): 939948939-948.

BackgroundInspiratory muscle training (IMT) strategies can reduce ICU length of stay and optimize recovery in critically ill patients. Our objective was to compare IMT combined with spontaneous breathing with T-piece in tracheostomized subjects.MethodsTracheostomized critically ill subjects who were ready to wean were selected and randomly allocated to one of 2 groups: electronically-assisted IMT (EIMT) or spontaneous breathing with T-piece. Electronically assisted IMT was delivered using 30% of maximal inspiratory pressure (manual EIMT or automatically adjusted loads). The following variables were analyzed: ICU length of stay, weaning time, maximal inspiratory pressure, rapid shallow breathing index, pressure (cm H2O), power (W), flow (L/s), volume (L), and energy (J).ResultsA total of 132 patients were assessed; 104 subjects were enrolled with EIMT, n = 51 (automatic EIMT, n = 25 and manual EIMT n = 26), or spontaneous breathing with T-piece group, n = 53. The Acute Physiology and Chronic Health Evaluation II score was significantly higher (P = .02) in subjects in the manual EIMT group. Weaning time did not differ significantly between groups (8.55 ± 6.48 d and 10.86 ± 6.48 d, EIMT and spontaneous breathing with T-piece group, respectively; P = .23). Weaning success rates (75%) were lower in the manual EIMT group. Invasive mechanical ventilation time was longer but not significantly different (P = .21) in the spontaneous breathing with T-piece group. Maximal inspiratory pressure was significantly higher in the spontaneous breathing with T-piece and the automatic EIMT groups (P < .001 and P = .007, respectively). Pressure, power, and energy values were significantly higher in the manual EIMT group (P < .001, P = .003, and P = .003, respectively).ConclusionsIMT modalities in this trial had no significant impacts on weaning time or successful weaning rates.Copyright © 2022 by Daedalus Enterprises.

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