Desenvolvimento de um dispositivo de treinamento muscular inspiratório adaptável ao ventilador mecânico por manufatura aditiva

Abstract

Introduction: Weaning from mechanical ventilation (MV), the transition from artificial to spontaneous ventilation, takes up around 40% of the total MV time. Emerging evidence points to inspiratory muscle training (IMT) as a promising strategy for strengthening the inspiratory muscles and reducing weaning time from MV, however, many patients undergoing difficult weaning who cannot tolerate disconnection from the mechanical ventilator fail to perform IMT. The objective of this work is to develop a linear pressure loading device using additive manufacturing, which promotes inspiratory muscle strengthening without the need to disconnect the ventilator. Methodology: The study was carried out in three phases, starting with a bibliographic survey through a normative review on devices with threshold load used for muscle strengthening in patients undergoing difficult weaning, the intervention protocol and outcome. Followed by the development and manufacturing of the device using additive manufacturing (AM) and the third, the bench test carried out with the mechanical ventilator and test lung, to confirm the efficiency of the load graduation, valve operation and whether there are leaks in the ventilator circuit. mechanic. Result: Our regulatory review identified that most studies used devices with linear load, mainly the Threshold IMT® and POWERbreath®, all of which require disconnection from the MV to perform strengthening. IMT is effective in increasing MIP and weaning from MV. The prototype developed by AM was effective in adapting to the mechanical ventilator and allowed its components to impose a load on inspiration and oscillate between flow with resistance and normal flow, without the need for disconnection. Conclusion: The prototype developed by AM in this research will allow for inspiratory muscle training for previously unselected MV-dependent patients, as it does not require disconnection from the ventilator.