Inspiratory Muscle Training Prevents Diaphragmatic Atrophy in Mechanically Ventilated COVID-19 Patients

Background: Unloading the diaphragm by mechanical ventilation results in diaphragmatic dysfunction and atrophy, a condition recognized in critical care settings as ventilator-induced diaphragmatic dysfunction (VIDD). This condition contributes to prolonged mechanical ventilation, extubation failure...

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Autores principales:	Toqa El Naggar, Hany Obaya, Azza Ismail, Rashida Azzam, Abdulrahman El Naggar
Formato:	article
Lenguaje:	EN
Publicado:	Al-Azhar University, Faculty of Medicine (Damietta) 2021
Materias:	diaphragmatic dysfunction mechanical ventilation diaphragmatic atrophy icu rehabilitation covid-19 Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/69a444b9e7f349ccaa38dac3db5a199f
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spelling	oai:doaj.org-article:69a444b9e7f349ccaa38dac3db5a199f2021-12-02T19:36:37ZInspiratory Muscle Training Prevents Diaphragmatic Atrophy in Mechanically Ventilated COVID-19 Patients2636-41742682-378010.21608/ijma.2021.84944.1339https://doaj.org/article/69a444b9e7f349ccaa38dac3db5a199f2021-10-01T00:00:00Zhttps://ijma.journals.ekb.eg/article_189166_b69391a5af0f440fc0f58995bdaf5c4b.pdfhttps://doaj.org/toc/2636-4174https://doaj.org/toc/2682-3780Background: Unloading the diaphragm by mechanical ventilation results in diaphragmatic dysfunction and atrophy, a condition recognized in critical care settings as ventilator-induced diaphragmatic dysfunction (VIDD). This condition contributes to prolonged mechanical ventilation, extubation failure and higher risk of mortality.The aim of The Study: The current study aimed to investigate the effectiveness of inspiratory muscle training in preventing or reversing diaphragmatic atrophy in mechanically ventilated COVID-19 patients.Materials and Methods: 55 intubated, mechanically ventilated patients with hypoxic respiratory failure due to COVID-19 were randomly assigned into study (n = 32) and control (n = 23) groups. The former received inspiratory muscle training with the routine physiotherapy programme and the latter received routine physiotherapy only. Diaphragmatic thickness was measured and compared in both groups using ultrasonography.Results: In the study group, diaphragmatic thickness at end of inspiration and expiration significantly increased by 14% and 8% respectively (p < 0.001). The increase in thickness fraction for this group (7.5%) was statistically insignificant (p > 0.05). In the control group, there was a significant decrease in all three parameters (p < 0.001).Conclusion: Inspiratory muscle training by adjusting the ventilator’s trigger sensitivity is a safe, effective and feasible method that can successfully prevent diaphragmatic atrophy in mechanically ventilated, COVID-19 patients.Toqa El NaggarHany ObayaAzza IsmailRashida AzzamAbdulrahman El NaggarAl-Azhar University, Faculty of Medicine (Damietta)articlediaphragmatic dysfunctionmechanical ventilationdiaphragmatic atrophyicu rehabilitationcovid-19Medicine (General)R5-920ENInternational Journal of Medical Arts, Vol 3, Iss 4, Pp 1761-1771 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diaphragmatic dysfunction mechanical ventilation diaphragmatic atrophy icu rehabilitation covid-19 Medicine (General) R5-920
spellingShingle	diaphragmatic dysfunction mechanical ventilation diaphragmatic atrophy icu rehabilitation covid-19 Medicine (General) R5-920 Toqa El Naggar Hany Obaya Azza Ismail Rashida Azzam Abdulrahman El Naggar Inspiratory Muscle Training Prevents Diaphragmatic Atrophy in Mechanically Ventilated COVID-19 Patients
description	Background: Unloading the diaphragm by mechanical ventilation results in diaphragmatic dysfunction and atrophy, a condition recognized in critical care settings as ventilator-induced diaphragmatic dysfunction (VIDD). This condition contributes to prolonged mechanical ventilation, extubation failure and higher risk of mortality.The aim of The Study: The current study aimed to investigate the effectiveness of inspiratory muscle training in preventing or reversing diaphragmatic atrophy in mechanically ventilated COVID-19 patients.Materials and Methods: 55 intubated, mechanically ventilated patients with hypoxic respiratory failure due to COVID-19 were randomly assigned into study (n = 32) and control (n = 23) groups. The former received inspiratory muscle training with the routine physiotherapy programme and the latter received routine physiotherapy only. Diaphragmatic thickness was measured and compared in both groups using ultrasonography.Results: In the study group, diaphragmatic thickness at end of inspiration and expiration significantly increased by 14% and 8% respectively (p < 0.001). The increase in thickness fraction for this group (7.5%) was statistically insignificant (p > 0.05). In the control group, there was a significant decrease in all three parameters (p < 0.001).Conclusion: Inspiratory muscle training by adjusting the ventilator’s trigger sensitivity is a safe, effective and feasible method that can successfully prevent diaphragmatic atrophy in mechanically ventilated, COVID-19 patients.
format	article
author	Toqa El Naggar Hany Obaya Azza Ismail Rashida Azzam Abdulrahman El Naggar
author_facet	Toqa El Naggar Hany Obaya Azza Ismail Rashida Azzam Abdulrahman El Naggar
author_sort	Toqa El Naggar
title	Inspiratory Muscle Training Prevents Diaphragmatic Atrophy in Mechanically Ventilated COVID-19 Patients
title_short	Inspiratory Muscle Training Prevents Diaphragmatic Atrophy in Mechanically Ventilated COVID-19 Patients
title_full	Inspiratory Muscle Training Prevents Diaphragmatic Atrophy in Mechanically Ventilated COVID-19 Patients
title_fullStr	Inspiratory Muscle Training Prevents Diaphragmatic Atrophy in Mechanically Ventilated COVID-19 Patients
title_full_unstemmed	Inspiratory Muscle Training Prevents Diaphragmatic Atrophy in Mechanically Ventilated COVID-19 Patients
title_sort	inspiratory muscle training prevents diaphragmatic atrophy in mechanically ventilated covid-19 patients
publisher	Al-Azhar University, Faculty of Medicine (Damietta)
publishDate	2021
url	https://doaj.org/article/69a444b9e7f349ccaa38dac3db5a199f
work_keys_str_mv	AT toqaelnaggar inspiratorymuscletrainingpreventsdiaphragmaticatrophyinmechanicallyventilatedcovid19patients AT hanyobaya inspiratorymuscletrainingpreventsdiaphragmaticatrophyinmechanicallyventilatedcovid19patients AT azzaismail inspiratorymuscletrainingpreventsdiaphragmaticatrophyinmechanicallyventilatedcovid19patients AT rashidaazzam inspiratorymuscletrainingpreventsdiaphragmaticatrophyinmechanicallyventilatedcovid19patients AT abdulrahmanelnaggar inspiratorymuscletrainingpreventsdiaphragmaticatrophyinmechanicallyventilatedcovid19patients
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Inspiratory Muscle Training Prevents Diaphragmatic Atrophy in Mechanically Ventilated COVID-19 Patients

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