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dc.contributor.authorBissett, B.
dc.contributor.authorLeditschke, I.
dc.contributor.authorParatz, Jennifer D.
dc.contributor.authorBoots, R.
dc.date.accessioned2017-05-03T12:02:34Z
dc.date.available2017-05-03T12:02:34Z
dc.date.issued2012
dc.date.modified2014-06-11T01:13:24Z
dc.identifier.issn14480271
dc.identifier.urihttp://hdl.handle.net/10072/59974
dc.description.abstractRespiratory muscle dysfunction is associated with prolonged and difficult weaning from mechanical ventilation. This dysfunction in ventilator-dependent patients is multifactorial: there is evidence that inspiratory muscle weakness is partially explained by disuse atrophy secondary to ventilation, and positive end-expiratory pressure can further reduce muscle strength by negatively shifting the length-tension curve of the diaphragm. Polyneuropathy is also likely to contribute to apparent muscle weakness in critically ill patients, and nutritional and pharmaceutical effects may further compound muscle weakness. Moreover, psychological influences, including anxiety, may contribute to difficulty in weaning. There is recent evidence that inspiratory muscle training is safe and feasible in selected ventilator-dependent patients, and that this training can reduce the weaning period and improve overall weaning success rates. Extrapolating from evidence in sports medicine, as well as the known effects of inspiratory muscle training in chronic lung disease, a theoretical model is proposed to describe how inspiratory muscle training enhances weaning and recovery from mechanical ventilation. Possible mechanisms include increased protein synthesis (both Type 1 and Type 2 muscle fibres), enhanced limb perfusion via dampening of a sympathetically-mediated metaboreflex, reduced lactate levels and modulation of the perception of exertion, resulting in less dyspnoea and enhanced exercise capacity.
dc.description.peerreviewedYes
dc.description.publicationstatusYes
dc.format.extent360801 bytes
dc.format.mimetypeapplication/pdf
dc.languageEnglish
dc.language.isoeng
dc.publisherAustralian Society of Anaesthetists
dc.publisher.placeAustralia
dc.publisher.urihttp://www.aaic.net.au/Document/?D=20110289
dc.relation.ispartofstudentpublicationN
dc.relation.ispartofpagefrom236
dc.relation.ispartofpageto246
dc.relation.ispartofissue2
dc.relation.ispartofjournalAnaesthesia and Intensive Care
dc.relation.ispartofvolume40
dc.rights.retentionY
dc.subject.fieldofresearchBiomedical and clinical sciences
dc.subject.fieldofresearchPhysiotherapy
dc.subject.fieldofresearchcode32
dc.subject.fieldofresearchcode420106
dc.titleRespiratory dysfunction in ventilated patients: can inspiratory muscle training help?
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.rights.copyright© 2012 Australian Society of Anaesthetists. The attached file is reproduced here in accordance with the copyright policy of the publisher. Please refer to the journal's website for access to the definitive, published version.
gro.hasfulltextFull Text
gro.griffith.authorParatz, Jenny D.


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