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Effect of the 'upper limb trainer' on lung volume during the weaning phase with ICU patients: an exploring study

The goal of this study was to find out whether daily exercise with the upper limb trainer (ULT) has an influence on lung volumes and, by consequence, on the diaphragm. By doing so we hope to improve the process of weaning from mechanical ventilation in order to prevent weaning failure.

We tested four adult patients at our university hospital intensive care unit in Belgium. They were ventilated for at least 1 week and fell within the scope of the following weaning criteria: PaO2/FiO2 > 200, PEEP ≤ 5 cmH2O, HF < 120 bpm and RR ≤ 35 breaths/min.

The patients were asked to perform 10 min of cycling with the ULT. This was done daily, up to the moment that the patients were extu-bated or until they no longer fell within the scope of the criteria. One patient was tested 2 days, the others only 1 day.

Respiratory rate, tidal volume and minute volume were measured before, during and after cycling. Heart rate and blood pressure were monitored continuously. Before and after the testing, arterial blood was taken and PaO2, PaCO2, pH and lactate were measured. We found a decrease in pH, but an increase in PaCO2. This seems to indicate that this exercise was too demanding for our patients. The fact that the respiratory rate increased during cycling while the tidal volume stabilized proved that there was no shallow breathing.

More investigations to confirm these findings have to be performed. Moreover, a parameter immediately indicating the load of the exercise needs to be found. Our findings suggest that arm exercise with the ULT could have a positive influence on the diaphragm and, hence, can be useful for patients who fail to wean.

Acknowledgement

This work was performed in association with the 'Arteveldehogeschool', Department of Health Care, Ghent.

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Van den Steen, E., DeCorte, L., D'Haese, R. et al. Effect of the 'upper limb trainer' on lung volume during the weaning phase with ICU patients: an exploring study. Crit Care 7, P175 (2003). https://doi.org/10.1186/cc2064

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  • DOI: https://doi.org/10.1186/cc2064

Keywords

  • Blood Pressure
  • Heart Rate
  • Lactate
  • Intensive Care Unit
  • Mechanical Ventilation