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Standardization of IMT Dosage (UTIT) in Mechanical Ventilation. (UTIT-IMT)

10. august 2026 opdateret af: Jose J Zaragoza, MD MSc, Hospital H+ Queretaro

Standardization of Inspiratory Muscle Training Dose in Mechanically Ventilated Patients: A Randomized Clinical Trial Using the Total Inspiratory Work Unit (UTIT).

Respiratory muscle weakness prolongs mechanical ventilation (MV) and delays weaning. Currently, there is no standardized dosage for Inspiratory Muscle Training (IMT) in the ICU. This study aims to define an optimal IMT dosage using a new metric called "Total Inspiratory Work Unit" (UTIT), which integrates intensity, repetition, and frequency.

The study compares three daily dosage regimens (1,000 UTIT, 2,000 UTIT, and 3,000 UTIT) adjusted daily based on the patient's Negative Inspiratory Force (NIF). The goal is to determine the optimal dose-response relationship for improving inspiratory muscle strength (PiMax) and reducing the duration of mechanical ventilation.

Studieoversigt

Status

Tilmelding efter invitation

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This is a randomized clinical trial conducted at Hospital H+ Querétaro. Eligible intubated patients will be assigned to one of three intervention groups differing in the daily volume of inspiratory work.

The "Total Inspiratory Work Unit" (UTIT) is defined as: UTIT = (Target NIF %) x (Number of Breaths per Session) x (Number of Sessions per Day).

Intensity is adjusted daily to maintain the target UTIT dose. The study utilizes a threshold loading device (POWERbreathe K5) with real-time feedback. Safety parameters (SpO2, HR, FR, MAP) are monitored continuously during sessions. The intervention continues until successful weaning, extubation, ICU discharge, or death.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

60

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Querétaro
      • Querétaro City, Querétaro, Mexico, 76000
        • Hospital H+ Querétaro, Santiago de Querétaro, Querétaro

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Adult patients (>18 years of age) admitted to the Intensive Care Unit (ICU).
  • Invasive mechanical ventilation support for more than 48-72 hours.
  • Hemodynamic stability (defined as absence of vasopressors or receiving stable doses).
  • Adequate oxygenation and ventilatory parameters: PEEP < 10 cmH2O, FiO2 < 0.6, and PaO2/FiO2 ratio > 150-200.
  • Ability to cooperate with instructions or absence of deep sedation.

Exclusion Criteria:

  • Pre-existing neuromuscular pathology directly affecting respiratory muscles.
  • Severe thoracic trauma or recent thoracic surgery.
  • Unresolved pneumothorax or bronchopleural fistula.
  • Severe hemodynamic instability or severe cardiac arrhythmias.
  • Level of sedation that prevents active participation in sessions.
  • Pregnancy

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Low Dose Group (1,000 UTIT)

Participants receive a daily IMT dosage of 1,000 Total Inspiratory Work Units (UTIT).

Intensity: 30% of the patient's baseline Negative Inspiratory Force (NIF).

Repetitions: 30 breaths per session.

Frequency: 1 session per day

Respiratory rehabilitation training using a specific threshold loading device (POWERbreathe K5) with real-time feedback. The intervention aims to strengthen inspiratory muscles (diaphragm and intercostals). The daily dosage is calculated using the Total Inspiratory Work Unit (UTIT) formula, adjusted daily based on the patient's Negative Inspiratory Force (NIF).
Eksperimentel: Intermediate Dose Group (2,000 UTIT)

Participants receive a daily IMT dosage of 2,000 Total Inspiratory Work Units (UTIT).

Intensity: 50% of the patient's baseline Negative Inspiratory Force (NIF).

Repetitions: 60 breaths per session.

Frequency: 2 sessions per day.

Respiratory rehabilitation training using a specific threshold loading device (POWERbreathe K5) with real-time feedback. The intervention aims to strengthen inspiratory muscles (diaphragm and intercostals). The daily dosage is calculated using the Total Inspiratory Work Unit (UTIT) formula, adjusted daily based on the patient's Negative Inspiratory Force (NIF).
Eksperimentel: High Dose Group (3,000 UTIT)

Participants receive a daily IMT dosage of 3,000 Total Inspiratory Work Units (UTIT).

Intensity: 80% of the patient's baseline Negative Inspiratory Force (NIF).

Repetitions: 60 breaths per session.

Frequency: 3 sessions per day.

Respiratory rehabilitation training using a specific threshold loading device (POWERbreathe K5) with real-time feedback. The intervention aims to strengthen inspiratory muscles (diaphragm and intercostals). The daily dosage is calculated using the Total Inspiratory Work Unit (UTIT) formula, adjusted daily based on the patient's Negative Inspiratory Force (NIF).

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in Maximal Inspiratory Pressure (Pimax)
Tidsramme: From baseline (study entry) up to successful weaning, extubation, or ICU discharge (up to 30 days).
Change in maximal inspiratory pressure measured in cmH₂O using the POWERbreathe K5 device to evaluate inspiratory muscle strength from baseline to the end of the intervention.
From baseline (study entry) up to successful weaning, extubation, or ICU discharge (up to 30 days).
Total Duration of Mechanical Ventilation
Tidsramme: From the initiation of mechanical ventilation until successful extubation or ICU discharge (up to 30 days)
Total number of consecutive days a patient requires invasive mechanical ventilation support via endotracheal tube.
From the initiation of mechanical ventilation until successful extubation or ICU discharge (up to 30 days)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Duration of the Weaning Process
Tidsramme: From the start of the weaning process up to successful extubation (up to 30 days)
Number of days from the first spontaneous breathing trial (SBT) or initiation of weaning protocol until successful extubation
From the start of the weaning process up to successful extubation (up to 30 days)
Reintubation Rate Within 72 Hours
Tidsramme: Within 72 hours post-extubation
Percentage of patients who require reintubation within 72 hours following initial planned extubation.
Within 72 hours post-extubation
Length of Stay in Intensive Care Unit (ICU)
Tidsramme: From study enrollment until ICU discharge (up to 30 days).
Total number of days the patient remains admitted to the ICU.
From study enrollment until ICU discharge (up to 30 days).

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. august 2025

Primær færdiggørelse (Anslået)

30. august 2026

Studieafslutning (Anslået)

1. november 2026

Datoer for studieregistrering

Først indsendt

3. august 2026

Først indsendt, der opfyldte QC-kriterier

10. august 2026

Først opslået (Faktiske)

12. august 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

12. august 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

10. august 2026

Sidst verificeret

1. august 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • CEI2025-12V1
  • REHAB-25-1 (Anden identifikator: CEI2025-12V1)

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