IMweanT
Trial question
What is the role of high-intensity inspiratory muscle training in patients with weaning difficulties?
Study design
Single center
Single blinded
RCT
Population
Characteristics of study participants
43.0% female
57.0% male
N = 90
90 patients (39 female, 51 male).
Inclusion criteria: patients with weaning difficulties.
Key exclusion criteria: pre-existing neuromuscular disease; agitation; hemodynamically unstable; hemoptysis; diaphoresis; spinal cord injury above T8; skeletal pathology impairing chest wall movements; poor general prognosis or fatal outcome.
Interventions
N=44 high-intensity inspiratory muscle training (maximal inspirations initiated from residual volume against an external load representing 30-50% of maximal inspiratory pressure).
N=46 low-intensity inspiratory muscle training (maximum inspirations performed against a load ≤ 10% of maximal inspiratory pressure).
Primary outcome
Weaning success
64%
76%
76.0 %
57.0 %
38.0 %
19.0 %
0.0 %
High-intensity inspiratory muscle
training
Low-intensity inspiratory muscle
training
No significant
difference ↔
No significant difference in weaning success (64% vs. 76%; ARD -12, 95% CI -41.29 to 17.29).
Secondary outcomes
No significant difference in weaning duration (45 days vs. 37 days; AD 8 days, 95% CI -7.93 to 23.93).
No significant difference in maximal inspiratory pressure (15 cmH₂O vs. 14 cmH₂O; AD 1 cmH₂O, 95% CI -4.21 to 6.21).
Significant increase in FVC (0.33 L vs. 0.16 L; AD 0.17 L, 95% CI 0.01 to 0.33).
Conclusion
In patients with weaning difficulties, high-intensity inspiratory muscle training was not superior to low-intensity inspiratory muscle training with respect to weaning success.
Reference
Marine Van Hollebeke, Diego Poddighe, Mariana Hoffman et al. Similar Weaning Success Rate with High-Intensity and Sham Inspiratory Muscle Training: A Randomized Controlled Trial (IMweanT). Am J Respir Crit Care Med. 2025 Mar;211(3):381-390.
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