The Effect of Inspiratory Muscle Training on Diaphragmatic Function in Mechanically Ventilated Patients
Condition: Intensive Care Unit Acquired Weakness
MeSH terms: Respiratory Aspiration
Study type: Interventional

Summary: 
      In this study, the effect of inspiratory muscle training on diaphragmatic functions will be
      investigated radiologically in mechanically ventilated patients.
    

Detailed description: 
      Many patients who receive treatment in intensive care need mechanical ventilation support.
      Invasive mechanical ventilation is an application used in critically ill patients to provide
      pulmonary gas exchange and to relieve the respiratory muscles. Mechanical ventilation and
      long- term bed rest induced extremity muscle weakness is a common condition in patients
      hospitalized in the intensive care unit. Acquired muscle weakness in intensive care is
      associated with poor prognosis and high mortality At the same time, mechanical ventilation
      can lead to the development of respiratory muscle dystrophy and atrophy.

      Recently, a similar concern has arisen about the potential negative effects of mechanical
      ventilation on respiratory muscles. This condition is called ventilator-induced diaphragmatic
      dysfunction In patients with mechanical ventilation, dysfunction, muscle fiber type change
      and barotrauma are seen especially in the diaphragm, which is the primary inspiratory muscle.
      Diaphragmatic dysfunction may promote prolong of intubation, weaning difficulties and risk of
      increase reintubation in patients who are mechanically ventilated.

      The effect of inspiratory muscle training, which is applied in addition to conventional
      respiratory physiotherapy, on diaphragmatic dysfunction, on the weaning process and the long
      of stay in intensive care has not been fully elucidated, and a limited number of studies have
      been conducted on this subject It has been reported that in patients with prolonged
      mechanical ventilation, diaphragmatic peak contraction velocity, peak relaxation velocity,
      movement speed, velocity time integral are lower than healthy individuals and this is
      correlated with failure to wean from mechanical ventilation. We could not find any report and
      clinical trial in the literature evaluation the effect of conventional physiotherapy and
      additional inspiratory muscle training on diaphragmatic tissue movement velocity and
      diaphragm thickness using detailed radiological methods in intensive care patients dependent
      on mechanical ventilation. In this context, our not working has a unique value. Our study
      will contribute to elucidating the mechanisms that affect the weaning process from mechanical
      ventilation in intensive care patients. It is aimed to develop strategies that will shorten
      the long of stay in intensive care and total hospital stay with therapeutic approaches that
      enable patients to be extubated as early as possible.
    

Intervention name(s): Conventional Physiotherapy; Conventional Physiotherapy+ inspiratory muscle training; inspiratory muscle training
Intervention type(s): Other; Other; Other
Intervention description(s): Conventional Physiotherapy to contain breathing and thoracal expansion exercises, bronchial hygiene techniques and gradual mobilization in 1 time a day.; Conventional Physiotherapy to contain breathing and thoracal expansion exercises, bronchial hygiene techniques and gradual mobilization in 1 time a day. In this group addition to conventional physiotherapy inspiratory muscle training will be performed with the threshold-loaded inspiratory muscle training device, starting at 30% of the maximum inspiratory mouth pressure value, during 5 days, in 2 sessions, 4 sets per day, 6-8 breaths in each set and 2 minutes of rest between sets.; In this group inspiratory muscle training will be performed with the threshold-loaded inspiratory muscle training device, starting at 30% of the maximum inspiratory mouth pressure value, during 5 days, in 2 sessions, 4 sets per day, 6-8 breaths in each set and 2 minutes of rest between sets.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Parallel Assignment Randomized Healthy participants
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: mechanical ventilated patients; Inspiratory muscle training; Physiotherapy and rehabilitation; diaphragmatic issue doppler; Respiratory muscle thickness