Similar Weaning Success Rate with High-Intensity and Sham Inspiratory Muscle Training: A Randomized Controlled Trial (IMweanT).

IMT protocols involve performing daily sets of breaths against external loads.

IMT方案包括每日进行一系列对抗外部负荷的呼吸练习。

However, the impact of IMT on weaning outcomes while incorporating sham control interventions remains unclear.

然而，将模拟控制干预纳入考虑时，间歇性肌力训练（IMT）对撤机结果的影响尚不明确。

Objectives: To compare the effects of a high-intensity IMT (Hi-IMT) intervention with a sham low-intensity (Lo-IMT) control group on weaning outcomes and respiratory muscle and pulmonary function 28 days after inclusion in patients with weaning difficulties.

目标：比较高强度间歇性肌力训练（Hi-IMT）干预与模拟低强度（Lo-IMT）对照组在纳入撤机困难患者28天后对撤机结果以及呼吸肌和肺功能的影响。

Methods: Both groups underwent daily IMT sessions until successful weaning or a maximum of 28 days.

方法：两组患者均接受每日间歇性机械通气（IMT）治疗，直至成功脱机或达到最大治疗周期28天。

The Hi-IMT group (n = 44; 61% male; aged 57 ± 15 yr) performed maximal inspirations initiated from residual volume against an external load representing 30-50% of maximal inspiratory pressure (PImax), and the control group (n = 46; 52% male; aged 60 ± 12 yr) performed maximal inspirations against a load ⩽10% PImax.

高强度间歇性机械通气（Hi-IMT）组（n = 44，男性占61%，平均年龄57 ± 15岁）从残气量开始进行最大吸气，对抗外部负荷，该负荷相当于最大吸气压力（PImax）的30-50%，而对照组（n = 46，男性占52%，平均年龄60 ± 12岁）进行最大吸气，对抗的负荷不超过PImax的10%。

Measurements and Main Results: Training adherence (completed/planned sessions) was comparable between the groups (Hi-IMT, 77 ± 20%; Lo-IMT, 72 ± 17%; P = 0.25).

测量和主要结果：两组之间的训练依从性（完成/计划的训练次数）相当（Hi-IMT，77 ± 20%；Lo-IMT，72 ± 17%；P = 0.25）。

Weaning success (64% Hi-IMT and 76% Lo-IMT; P = 0.43) and weaning duration (Hi-IMT, 45 ± 48 d; Lo-IMT, 37 ± 26 d; P = 0.33) were similar between groups.

脱机成功率（Hi-IMT组为64%，Lo-IMT组为76%；P = 0.43）和脱机持续时间（Hi-IMT组为45 ± 48天；Lo-IMT组为37 ± 26天；P = 0.33）在两组之间相似。

Both groups similarly improved PImax (Hi-IMT, +15 cm H2O [95% confidence interval(CI), 9, 20]; Lo-IMT, +14 cm H2O [95% CI, 9, 19]; P = 0.72).

两组在改善最大吸气压（PImax）方面相似（Hi-IMT组，+15 cm H2O [95% 置信区间 (CI), 9, 20]；Lo-IMT组，+14 cm H2O [95% CI, 9, 19]；P = 0.72）。

FVC improved more in the Hi-IMT group than in the Lo-IMT group (Hi-IMT, +0.33 L [95% CI, 0.22, 0.43]; Lo-IMT, +0.16 L [95% CI, 0.07, 0.25]; P = 0.04).

在高强间歇性肌力训练（Hi-IMT）组中，用力肺活量（FVC）的改善比低强间歇性肌力训练（Lo-IMT）组更为显著（Hi-IMT组，+0.33 L [95% 置信区间 (CI), 0.22, 0.43]；Lo-IMT组，+0.16 L [95% CI, 0.07, 0.25]；P = 0.04）。

Conclusions: Both high-intensity IMT and sham low-intensity IMT, with high adherence to the protocol, resulted in similar weaning success rates and pronounced improvements in maximal inspiratory muscle strength.

结论：高强度的间歇性肌力训练（IMT）和模拟低强度IMT，均在高度遵循方案的情况下，导致了相似的脱机成功率和最大吸气肌力量的显著改善。

Clinical trial registered with www.clinicaltrials.gov (NCT03240263).

临床试验已注册于www.clinicaltrials.gov (NCT03240263)。