Safety and feasibility of inspiratory muscle training for hospitalized patients undergoing hematopoietic stem cell transplantation

Abstract

<b>Background:</b> Patients undergoing hematopoietic stem cell transplantation (HSCT) usually experienced respiratory muscle weakness. The inspiratory muscle training (IMT) at HSCT has not been studied yet. <b>Objective:</b> To evaluate the safety, feasibility and preliminary effectiveness of the IMT for hospitalized patients undergoing HSCT. <b>Methods:</b> This is a randomized controlled feasibility study. Patients hospitalized for HSCT were allocated to a control group (conventional therapy) or to a IMT group (IMT + conventional therapy). The IMT was carried out at 40% of maximal inspiratory pressure (MIP), 5 sessions weekly, 10-20 min/session. The primary outcomes were safety and feasibility (recruitment, adherence and attrition rates) of IMT. Respiratory strength, respiratory rate and oxygen saturation were evaluated at admission and hospital discharge. Symptoms related to the respiratory system (oxygen therapy, bleeding, dyspnea and acute pulmonary edema) were also evaluated. <b>Results:</b> Patients were allocated to a IMT group (N=15; 43.6 yr) or to a control group (N=16; 46.6 yr). The recruitment rate was 100%, the adherence rate to IMT was 91% and attrition was 20%. It was observed 2 events (vomiting; oxygen desaturation) in 126 sessions (1.5%). MIP increased in the IMT group (P&lt;0.01). No differences were observed in respiratory rate and oxygen saturation between groups. It was observed trends to negative outcomes in the control group in comparison to IMT group for a need of oxygen therapy (18% vs. 6%), bleeding (12% vs. 6%), dyspnea (25% vs. 13%) and acute pulmonary edema (6% vs. 0%). <b>Conclusions:</b> The IMT is safe, feasible and improves the inspiratory muscle strength.