The Effect of Inspiratory Muscle Trainer (IMT) on Pimax, RSBI of Intubation Patients in Two Medical ICUs

Sung, Ya-Wen

Monday, 22 July 2013

Ya-Wen Sung, RN
Department of Nursing, Kaohsiung Medical University Hospital(KMUH), Kaohsiung, Taiwan
Yao-Mei Chen, PhD, RN
Department of Nursing/ College of Nursing, Kaohsiung Municipal HsiaoKang Hospital (KMHK)/ Kaohsiung Medical University, Kaohsiung, Taiwan

Learning Objective 1: the IMT to increase the index of Pimax, RSBI.

Learning Objective 2: increase the chance of successful extubation of intubated patients in ICU.

Method: The study adopted a quasi-experimental design. Two medical intensive care units in a medical center in southern Taiwan were selected and assigned as the experimental and the control units. The patients in the control unit (n=52) received the ordinary weaning training (i.e., T-piece trial for 2 hours daily). The patients inthe experimental unit (n=48) were additionally provided with the intervention of IMT. Set to the 30% Pimax level of the intubated patients, the IMT was applied for 20 minutes daily until the time for extubation or when the patient’s respiratory function was deteriorating. The levels of Pimax and RSBI before and after the interventions were collected as the outcome measures.

Results: Compared to the control group, IMT improved Pimax in the experimental group, continuously across the training period (t=5.797-5.872, p< .001). On the contrary, the Pimax in the control group only improved significantly until the day of extubation (t=1.540-2.186, p< .05). Patients from both groups did not change significantly on their RSBI (p> .05).

Conclusions: IMT may improved Pimax of intubated patients in medical ICUs and decreased the possible respiratory muscle fatigue when using ventilator. The study results suggest that incorporating IMT with ordinary chest care and respiratory therapy may be helpful for extubation. Such results provide supportive evidence in strengthening the respiratory muscle power, which, in turn, facilitate the weaning process of an intubated patients from a ventilator in the medical ICUs.

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