Standardization of IMT Dosage (UTIT) in Mechanical Ventilation. (UTIT-IMT)
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.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
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.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Luoghi di studio
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Querétaro
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Querétaro City, Querétaro, Messico, 76000
- Hospital H+ Querétaro, Santiago de Querétaro, Querétaro
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
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
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
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Sperimentale: 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).
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|
Sperimentale: 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).
|
|
Sperimentale: 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).
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Change in Maximal Inspiratory Pressure (Pimax)
Lasso di tempo: From baseline (study entry) up to successful weaning, extubation, or ICU discharge (up to 30 days).
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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.
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From baseline (study entry) up to successful weaning, extubation, or ICU discharge (up to 30 days).
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Total Duration of Mechanical Ventilation
Lasso di tempo: From the initiation of mechanical ventilation until successful extubation or ICU discharge (up to 30 days)
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Total number of consecutive days a patient requires invasive mechanical ventilation support via endotracheal tube.
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From the initiation of mechanical ventilation until successful extubation or ICU discharge (up to 30 days)
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Duration of the Weaning Process
Lasso di tempo: From the start of the weaning process up to successful extubation (up to 30 days)
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Number of days from the first spontaneous breathing trial (SBT) or initiation of weaning protocol until successful extubation
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From the start of the weaning process up to successful extubation (up to 30 days)
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Reintubation Rate Within 72 Hours
Lasso di tempo: Within 72 hours post-extubation
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Percentage of patients who require reintubation within 72 hours following initial planned extubation.
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Within 72 hours post-extubation
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Length of Stay in Intensive Care Unit (ICU)
Lasso di tempo: From study enrollment until ICU discharge (up to 30 days).
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Total number of days the patient remains admitted to the ICU.
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From study enrollment until ICU discharge (up to 30 days).
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Collaboratori e investigatori
Sponsor
Sponsor
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- CEI2025-12V1
- REHAB-25-1 (Altro identificatore: CEI2025-12V1)
Informazioni su farmaci e dispositivi, documenti di studio
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Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
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