Treino dos músculos inspiratórios em doentes submetidos a ventilação mecânica invasiva: : revisão sistemática da literatura

Daniel Silva; Isabel Oliveira; Paulo Azevedo

doi:10.33194/rper.2026.43864

Authors

Daniel Silva Unidade Local de Saúde São João, Porto, Portugal https://orcid.org/0009-0009-2220-0357
Isabel Oliveira Escola Superior de Enfermagem de Coimbra, Coimbra, Portugal https://orcid.org/0000-0001-6627-3907
Paulo Azevedo Escola Superior de Saúde Norte da Cruz Vermelha Portuguesa, Oliveira de Azeméis, Portugal https://orcid.org/0000-0003-4099-3329

DOI:

https://doi.org/10.33194/rper.2026.43864

Keywords:

Mechanical ventilation, ventilator weaning, rehabilitation, breathing exercises

Abstract

Introduction: Invasive mechanical ventilation (IMV) is essential in patients with respiratory failure. However, prolonged use can lead to inspiratory muscle weakness. Respiratory rehabilitation, particularly inspiratory muscle training (IMT), could be crucial for increasing inspiratory muscle strength and reducing weaning duration.

Methodology: A systematic review was carried out according to the Cochrane guidelines for Systematic Reviews of Interventions between January 2018 and July 2023. A search was conducted in MEDLINE, CINAHL Complete, SciELO, Embase and Cochrane Library. The search phrase was constructed from the MeSH terms critical care, artificial respiration and breathing exercises and other natural terms. Experimental or quasi-experimental studies of interventions assessing maximal inspiratory pressure (MIP) were included. Methodological quality was assessed using RoB2.

Results: Out of 3269 identified articles, two studies met the eligibility criteria. Both studies showed significant increases in MIP in both control and experimental groups, with no statistically significant differences in weaning time.

Discussion: The IMT techniques included automatic electronic and manual devices with a gradual flow resistive load and a threshold mechanical training device. IMT is feasible and well tolerated in patients on IMV. Despite improvements in quality of life and dyspnoea in the IMT group, there was no significant impact on MIP or ventilator weaning. The selected studies raise some concerns about the quality of the evidence.

Conclusion: IMT provided modest improvements in respiratory muscle strength. However, the results showed no significant impact on MIP or weaning time. Further research is needed to confirm the impact of IMT on ventilator weaning.

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