Métodos de treinamento da musculatura inspiratória de pacientes em ventilação mecânica

Abstract

The inability of the diaphragm to generate force, acquired by the reduced activation during mechanical ventilation, difficult the patient to resume their breath. Approximately 40% of the total time is spent for weaning the patient and dysfunction of the diaphragm is considered the major factor related to that time. Therefore, physiotherapists should be aware of early detection of respiratory muscle deconditioning, to begin rehabilitation, enabling the optimization of weaning. The objective of this review was to describe the methods of strengthening the inspiratory muscles in patients in mechanical ventilation and presenting muscle weakness resulting from this process. A search in the Medline database via PubMed was performed for the past 10 years. Twenty six articles were found, five were selected after reading the abstract and application of inclusion and exclusion criteria. The inspiratory muscle training was performed for four studies using the threshold device and only one adjusting the sensitivity of the ventilator. Three studies used a training intensity of moderate to high and a volume training of 3 to 5 sets, 6-8 repetitions, a once daily, 5-7 times per week. Three studies associated progressive spontaneous breathing periods and used breathing and limbs exercises. The inspiratory muscle training appears to be a therapeutic strategy that should be considered for the rehabilitation of critically ill patients with weaning mechanical ventilation difficult.