Entraînement en force des muscles inspirateurs du patient ventilé — de la dysfonction diaphragmatique au sevrage de la ventilation mécanique

Abstract

Invasive mechanical ventilation (MV) is a technique used to compensate acute respiratory failure. It allows the rest of inspiratory muscles and promotes their metabolic recovery. Paradoxically, complete inspiratory muscle rest by MVis responsible for specific impairment induced by ventilation. This impairment, recently described, is early, can prolong MV, and therefore delay weaning. Causes of weaning failure are often complex; however, imbalance between MVrelated and respiratory muscles capacity remains an important factor. In 1989, TK Aldrich first assumed that inspiratory muscle training may facilitate weaning from MV and shorten its duration. Therefore, the use of this technique appears clearly justified, considering MV-induced complications and costs of hospitalization in the intensive care unit. Reducing MV duration has become a real challenge. This article first attempts to focus at MV-related impairment of inspiratory muscles and its consequences. After reviewing the methods that allow assessing the function of respiratory muscles in ventilated patients, it will present some practical training modalities based on the medical literature. © SRLF et Springer-Verlag France 2013.