Introduction: Strengthening of the breathing muscles can improve patients' quality of life in ICU. Electronic trainers could allow training of a broader range of very weak patients, but safety and acceptability needs to be established. 

Aim: To evaluate the safety, feasibility, and acceptability of an electronic device to facilitate inspiratory muscle training (IMT) with critically ill patients requiring prolonged mechanical ventilation (≥5 days). 

Methods: Prospective observational cohort study, with convenience sampling in 2 tertiary ICUs. Daily training supervised by ICU physiotherapists was completed with the electronic IMT device. Feasibility was defined a priori as ≥ 80% of planned sessions completed. Patient-perceived acceptability was evaluated with a bespoke survey. 

Results: Forty participants completed 197 electronic IMT treatment sessions. Electronic IMT was feasible with 81% of planned sessions completed. There were 19 minor adverse events in 11 participants (10% sessions) and no major adverse events. All minor events were transient without clinical consequences (e.g. rise in systolic blood pressure >20mmHg). All participants that recalled completing electronic IMT sessions reported that the training was acceptable, with over 85% reporting electronic IMT was helpful or beneficial.

Conclusion: Electronic IMT is feasible and acceptable with ICU patients who require prolonged mechanical ventilation. As all minor adverse events were transient without clinical consequences, electronic IMT can be considered a relatively safe intervention in this cohort. 

• Electronic IMT is safe, feasible and acceptable in ICU patients undergoing prolonged mechanical ventilation (>5 days) and can be incorporated into clinical practice.

• The efficacy of electronic IMT in ICU patients should be explored in a randomised trial.

 

Bernie Bissett1, Marc Nickels2, Grant McMurray3, Katie Erwin4, Richie Talbot1, Mark Strong3, Anand Krishnan5, Frank Van Haren6

 

1.     Discipline of Physiotherapy, University of Canberra, Canberra ACT, 2617

2.     Physiotherapy Department, Ipswich Hospital, Brisbane, QLD, 

3.     Physiotherapy Department, Princess Alexandra Hospital, Brisbane, QLD

4.     Physiotherapy Department, Canberra Health Services, Garran ACT, 2606

5.     Intensive Care Unit, Princess Alexandra Hospital, Brisbane, QLD,

6.     College of Health and Medicine, ANU, Canberra, ACT, 2600