Ventilator inspiratory trigger sensitivity adjustment versus threshold device training on pulmonary functions in acute stroke patients
Year: 2026
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Patients with neurological disorders often need Prolonged Mechanical Ventilation (PMV).In those with sudden neurological issues, 17-33% receives intubation and ventilator support due to breathing difficulties, leading to unfavorable results and hospital death rates of 16-33%.Weakness in inspiratory muscles commonly occurs, particularly during extended ventilation periods, but inspiratory muscle training (IMT) may counteract these issues and support successful ventilator removal.Physical therapy thus contributes importantly by using multiple techniques to build respiratory muscle strength.This research aimed to evaluate ventilator inspiratory trigger sensitivity changes against threshold device exercises for their impact on lung function among patients with recent strokes.The trial involved 40 individuals (26 women, 14 men) aged 40-60 years suffering from acute stroke and needing mechanical ventilation, drawn from the stroke unit at Al-Kaser Al-Ainy Medical School, Cairo University, during June-August 2025.Random allocation placed participants into two equal groups: one using threshold IMT and the other with ventilator trigger pressure modifications.Lung compliance (mL/cmH2O) served as the main measure, alongside blood gas values like pH, PaCO2 (mmHg), PaO2 (mmHg), and HCO3 (mEq/L).Participants receiving ventilator adjustments (MV group) achieved notably larger gains in lung compliance (16.95±1.90)than the IMT group (11.10±1.07;p<0.001).The MV group also showed better PaO2 gains (29.30±0.92 vs. 20.30±2.36;p<0.001), greater PaCO2 drops (-6.66±2.22 vs. -4.21±1.81;p<0.001), higher PaO2/FiO2 rises (90.05±2.09vs. 59.85±2.08;p<0.001), stronger SaO2 improvements (4.57±0.94 vs. 2.81±0.62;p<0.001), larger pH increases (0.10±0.03 vs. 0.05±0.02;p<0.001), and more significant HCO3 reductions (-3.42±1.68 vs. -0.43±1.47;p<0.001).Ventilator pressure tweaks and IMT both enhanced breathing mechanics and gas exchange in stroke patients on ventilators, yet MV adjustments yielded better results across oxygenation, CO2 clearance, acid-base status, and compliance.These results point to ventilator optimization as a primary option for breathing problems, with IMT as a helpful supplement for cases avoiding or extending beyond mechanical support, potentially improving recovery and lowering complications.
Source: Perinatal Journal
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7124315249