Comparing 2 loading types during inspiratory muscle training in difficult to wean patients

Abstract

Background : Tapered flow resistive loading (TFRL) better accommodates the pressure-volume relationships of the inspiratory muscles than the commonly used pressure threshold loading (TL). It is unclear if TFRL elicits different breathing pattern responses compared to TL in patients with weaning difficulties. Aim : Compare acute breathing pattern and perceived symptoms in response to IMT sessions performed against equal initial inspiratory loading provided as either TL or TFRL in patients with weaning difficulties. Method : 21 patients (52±16years) with maximal inspiratory pressure (PImax): 35±14cmH2O and FVC: 0.85L±0.37L, performed two IMT sessions against TL or TFRL with an initial load of 42±15%PImax. Breath-by-breath data of breathing parameters were collected and patients rated their perceived symptoms afterwards. Results : For a given loading, TFRL allowed significantly larger inspiratory tidal volumes and inspiratory flow responses but inspiratory pressure was lower compared to TL. No differences in work of breathing or power were observed between the types of loading. Patients perceived TFRL as less unpleasant (Table 1). Conclusion : For a given loading, TFRL-IMT allows larger volume expansion and higher inspiratory flow responses compared to TL-IMT and patients perceived TFRL as less unpleasant. This might facilitate early implementation of IMT and improve training outcomes in patients with weaning difficulties. ![Figure][1]</img> Footnotes Cite this article as: ERJ Open Research 2022; 8: Suppl. 9, 13. This article was presented at the 2022 ERS Respiratory Failure and Mechanical Ventilation Conference, in session “Poster Session 2”. This is an ERS Respiratory Failure and Mechanical Ventilation Conference abstract. No full-text version is available. Further material to accompany this abstract may be available at [www.ers-education.org][2] (ERS member access only). [1]: pending:yes [2]: http://www.ers-education.org