Keywords
respiratory function
mechanical ventilation
dyspnea
muscle strength
respiratory rehabilitation
How to Cite
Abstract
Background:
Respiratory muscle weakness following invasive mechanical ventilation represents a significant clinical challenge in the recovery of critically ill patients. Inspiratory muscle training (IMT) has been proposed as a strategy to improve muscle strength and facilitate weaning from ventilatory support. However, its effectiveness on clinical outcomes such as dyspnea and respiratory function remains unclear.
Methods:
A systematic review was conducted following the PRISMA guidelines, with a protocol registered in PROSPERO (ID: CRD42023455075). Randomized controlled trials were searched in MEDLINE, Web of Science, and Scopus up to July 2023. Studies involving adults who had undergone invasive mechanical ventilation for more than 48 hours were included, comparing IMT with conventional treatments.
Primary outcomes were inspiratory muscle strength and respiratory function; secondary outcomes included dyspnea and quality of life. The Cochrane RoB2 tool was used to assess the risk of bias.
Results:
Four studies with a total of 376 participants were included. Three studies reported improvements in inspiratory muscle strength with IMT, although no consistent effects on respiratory function or dyspnea were observed. Only two studies assessed quality of life, with mixed results. None evaluated muscle mass. Methodological differences between studies, heterogeneity of devices and protocols, and short follow-up periods limited the strength of the conclusions.
Conclusions:
IMT shows potential for improving inspiratory muscle strength in adults post-mechanical ventilation, but its clinical impact on dyspnea and respiratory function remains uncertain. More rigorous trials with longer follow-up, standardized protocols, and greater emphasis on patient-centered outcomes are needed to support its inclusion in respiratory rehabilitation programs.
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