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Adequate gas exchange as indicated by a PaO2 above 60 mmHg while breathing with an FIO2 of 0.50 or less
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Be medically stable and ready to be weaned from the ventilator as determined by the attending physician
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Hemodynamically stable for 24 hours prior to participation or requiring only minimal intravenous pressor agents (dobutamine or dopamine ≤ 5 mcg/kg/min, phenyleprine ≤ 1 mcg/kg/min)
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Be able to follow simple verbal directions related to inspiratory muscle strength testing and training
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Receiving assist control or SIMV or pressure support ventilation via a tracheostomy, with SIMV ≤ 6 breaths/min, pressure support ventilation ≤ 15 cm H2O and PEEP ≤ 10 cmH2O
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Unable to sustain unsupported breathing for at least 72 consecutive hours following resolution of factor(s) precipitating respiratory failure
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Demonstrate normal hemidiaphragm positions on X-ray
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Not have any progressive neuromuscular disease such as amyotrophic lateral sclerosis, muscular dystrophy, multiple sclerosis, myasthenia gravis, or any other neuromuscular disorder that would interfere with responding to inspiratory muscle training
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Have an anticipated life expectancy of at least 12 months
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Have a core temperature between ≥36.5°C and ≤ 38.5°C
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Not have a spinal cord injury above T8
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Not have any skeletal pathology (scoliosis, flail chest, spinal instrumentation) that would seriously impair the movement of the chest wall and ribs
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Not using any type of home MV support prior to hospitalization
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Body mass index < 40 kg/m2
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Not require continuous sedative or analgesic agents that will depress respiratory drive or the ability to follow commands
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No excessive secretions (requiring suctioning more than once every hour)
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Not being considering for transfer to another hospital in the next
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28 days
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