Facilitates Ventilator Weaning by Negative Pressure Breathing that Strengthens Muscles
This automated inspiratory muscle training combines hardware and software components, strengthening the inspiratory muscles while a patient is receiving mechanical ventilation. Mechanical ventilation is employed when a patient experiences respiratory failure and is unable to maintain adequate gas exchange. Approximately 800,000 hospitalized Americans require mechanical ventilation each year and over 300,000 of these patients require specific respiratory treatment to wean from mechanical ventilation. When a ventilator is used long-term, the inspiratory muscles become atrophied and weak resulting in difficulty being liberated from mechanical ventilation. A recent clinical trial demonstrated that the human diaphragm experiences significant atrophy in as little as 18 hours. Inspiratory muscle strength training is a method to prevent weakening of this muscle group when patients receive mechanical ventilation support. Available methods of treating mechanical ventilation dependence include unassisted breathing trials, pressure support breathing, T-piece trials, weaning protocols, growth hormones, and inspiratory resistance training. However, none of the methods produce significant strength gains. University of Florida researchers have developed a method of strengthening inspiratory muscles during mechanical ventilation that combines hardware and software to impose a strength-training stimulus on the muscles of inspiration. Strengthening the inspiratory muscles aids in weaning the patient from mechanical ventilation dependency. Research by this team examining the impact of inspiratory muscle strength training on weaning outcome has shown an increase in the percentage of long-term, “failure to wean” patients who were weaned compared to usual care. The inspiratory muscle strength training utilized in this clinical trial can be integrated into a mechanical ventilator as a single device. The system can also make recommendations on progressing the training program, providing visual feedback to the patient and therapist during training sessions and displaying training progression over time.
Strengthening of inspiratory muscles during mechanical ventilation through combination of software and hardware
- NIH-sponsored study demonstrates 50 percent more “failure to wean” patients were successfully extubated with Inspiratory Muscle Strength Training than with traditional treatments
- Requires only 15 minutes of training per day, using a device either incorporated directly into conventional ventilator or when used as an external module with available ventilators
- Potentially reduces duration of overall mechanical ventilation, saving money and improving the clinical outcomes of patients
The inspiratory strength training module is either incorporated into a conventional ventilator or as a separate module for use with conventional ventilators. Hospital staff members use the software component to set a strength training load for an individual patient, which comprises 4 sets of 10 training breaths over a 15 minute period. The hardware component, an electromechanical device, provides a threshold inspiratory load to the patient’s breathing tube, forcing the patient to overcome the negative pressure when inhaling, strengthening the inspiratory muscles. The software component generates a report including graphical feedback regarding the patient’s progress; evaluation of the patient’s training efforts; and recommendations for modifications in training in real time. The technology has the ability to provide long-term progress and clinical advice.