PT  - JOURNAL ARTICLE
AU  - Irini Patsaki
AU  - Anna Christakou
AU  - Emmanouel Papadopoulos
AU  - Martha Katartzi
AU  - Alexandros Kouvarakos
AU  - Ilias Siempos
AU  - Dimitris Tsimouris
AU  - Anastasia Skoura
AU  - Antonina Xatzimina
AU  - Sotirios Malachias
AU  - Νikolaos Koulouris
AU  - Eirini Grammatopoulou
AU  - Spiros Zakinthinos
AU  - Eleni Ischaki
TI  - The combination of inspiratory muscle training and high-flow nasal cannula oxygen therapy for promoting weaning outcomes in difficult-to-wean patients: protocol for a randomised controlled trial
AID  - 10.1183/23120541.00088-2020
DP  - 2020 Jul 01
TA  - ERJ Open Research
PG  - 00088-2020
VI  - 6
IP  - 3
4099  - http://openres.ersjournals.com/content/6/3/00088-2020.short
4100  - http://openres.ersjournals.com/content/6/3/00088-2020.full
SO  - erjor2020 Jul 01; 6
AB  - Background According to the literature, 20–30% of intubated patients are difficult to wean off mechanical ventilation and have a prolonged intensive care unit (ICU) stay with detrimental effects on muscle strength, functional ability and quality of life. Inspiratory muscle training (IMT) via a threshold device has been proposed as an effective exercise for minimising the effects of mechanical ventilation on respiratory muscles of critically ill patients with prolonged weaning. In addition, high-flow nasal cannula (HFNC) oxygen has been proved to provide efficient support for both high- and low-risk patients after extubation, thus preventing re-intubation.Material and methods A randomised controlled trial was designed to assess the efficacy of combining IMT and HFNC as therapeutic strategies for patients with high risk for weaning failure. Once patients with prognostic factors of difficult weaning are awake, ventilated with support settings and cooperative, they will be randomised to one of the two following study groups: intervention group (IMT and HFNC) and control group (IMT and Venturi mask). IMT will start as soon as possible. Each allocated oxygen delivery device will be applied immediately after extubation. IMT intervention will continue until patients' discharge from ICU. The primary outcome is the rate of weaning failure. Secondary outcomes are maximal inspiratory and expiratory strength, endurance of respiratory muscles, global muscle strength, functional ability and quality of life along with duration of ventilation (days) and ICU and hospital length of stay.Conclusion The present study could significantly contribute to knowledge of how best to treat patients with difficult weaning and high risk of re-intubation.This RCT will provide a therapeutic strategic plan for difficult-to-wean patients, minimising their intubation period and length of ICU stay https://bit.ly/37CkxTB