Radiological and Cardiopulmonary Evaluation of the Effect of Inspiratory Muscle Training on Diaphragmatic Function in Mechanically Ventilated Patients in the Intensive Care Unit

Maximal inspiratory and expiratory pressure,Diaphragmatic B mode, M mode and Tissue Doppler Ultrasonographic Imagining,Respiratory Muscle Thickness,Physical Function Test (PFIT) battery,Medical Research Council(MRC) Strength Test,Acute Care Index of Function (ACIF)

Many patients who receive treatment in intensive care need mechanical ventilation support.
 Invasive mechanical ventilation is an application used in critically ill patients to provide
 pulmonary gas exchange and to relieve the respiratory muscles. Mechanical ventilation and
 long- term bed rest induced extremity muscle weakness is a common condition in patients
 hospitalized in the intensive care unit. Acquired muscle weakness in intensive care is
 associated with poor prognosis and high mortality At the same time, mechanical ventilation
 can lead to the development of respiratory muscle dystrophy and atrophy.
 
 Recently, a similar concern has arisen about the potential negative effects of mechanical
 ventilation on respiratory muscles. This condition is called ventilator-induced diaphragmatic
 dysfunction In patients with mechanical ventilation, dysfunction, muscle fiber type change
 and barotrauma are seen especially in the diaphragm, which is the primary inspiratory muscle.
 Diaphragmatic dysfunction may promote prolong of intubation, weaning difficulties and risk of
 increase reintubation in patients who are mechanically ventilated.
 
 The effect of inspiratory muscle training, which is applied in addition to conventional
 respiratory physiotherapy, on diaphragmatic dysfunction, on the weaning process and the long
 of stay in intensive care has not been fully elucidated, and a limited number of studies have
 been conducted on this subject It has been reported that in patients with prolonged
 mechanical ventilation, diaphragmatic peak contraction velocity, peak relaxation velocity,
 movement speed, velocity time integral are lower than healthy individuals and this is
 correlated with failure to wean from mechanical ventilation. We could not find any report and
 clinical trial in the literature evaluation the effect of conventional physiotherapy and
 additional inspiratory muscle training on diaphragmatic tissue movement velocity and
 diaphragm thickness using detailed radiological methods in intensive care patients dependent
 on mechanical ventilation. In this context, our not working has a unique value. Our study
 will contribute to elucidating the mechanisms that affect the weaning process from mechanical
 ventilation in intensive care patients. It is aimed to develop strategies that will shorten
 the long of stay in intensive care and total hospital stay with therapeutic approaches that
 enable patients to be extubated as early as possible.