Inspiratory Muscle Training Prevents Diaphragmatic Atrophy in Mechanically Ventilated COVID-19 Patients
El Naggar, T., Obaya, H., Ismail, A., Azzam, R., El Naggar, A. (2021). Inspiratory Muscle Training Prevents Diaphragmatic Atrophy in Mechanically Ventilated COVID-19 Patients. EKB Journal Management System, 3(4), 1761-1771. doi: 10.21608/ijma.2021.84944.1339
Toqa Emad El Naggar; Hany Ezzat Obaya; Azza Fekry Ismail; Rashida El Said Azzam; Abdulrahman Emad El Naggar. "Inspiratory Muscle Training Prevents Diaphragmatic Atrophy in Mechanically Ventilated COVID-19 Patients". EKB Journal Management System, 3, 4, 2021, 1761-1771. doi: 10.21608/ijma.2021.84944.1339
El Naggar, T., Obaya, H., Ismail, A., Azzam, R., El Naggar, A. (2021). 'Inspiratory Muscle Training Prevents Diaphragmatic Atrophy in Mechanically Ventilated COVID-19 Patients', EKB Journal Management System, 3(4), pp. 1761-1771. doi: 10.21608/ijma.2021.84944.1339
El Naggar, T., Obaya, H., Ismail, A., Azzam, R., El Naggar, A. Inspiratory Muscle Training Prevents Diaphragmatic Atrophy in Mechanically Ventilated COVID-19 Patients. EKB Journal Management System, 2021; 3(4): 1761-1771. doi: 10.21608/ijma.2021.84944.1339

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

International Journal of Medical Arts
Article 1, Volume 3, Issue 4, October 2021, Page 1761-1771  XML PDF (1.36 MB)
Document Type: Original Article
DOI: 10.21608/ijma.2021.84944.1339
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Authors
Toqa Emad El Naggar email orcid 1; Hany Ezzat Obaya2; Azza Fekry Ismail1; Rashida El Said Azzam3; Abdulrahman Emad El Naggarorcid 4
1Department of Physical Therapy for Internal Medicine, Critical Care and Elderly, Faculty of Physical Therapy, Modern University for Technology and Information, Egypt
2Department of Cardiopulmonary Disorders, Faculty of Physical Therapy, Cairo University, Egypt
3Department of Anaesthesia and Critical Care, Faculty of Medicine, Al-Azhar University, Egypt
4House Officer, Damietta Faculty of Medicine, Al-Azhar University, Egypt
Abstract
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.  
Keywords
Diaphragmatic Dysfunction; Mechanical Ventilation; Diaphragmatic Atrophy; ICU Rehabilitation; COVID-19
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