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Identifying the Optimal IMT Dose in ICU

Every year, many people in the UK need help breathing and are put on a machine called a ventilator in intensive care. Often, their main breathing muscle, called the diaphragm, gets weak. This can mean they stay on the ventilator and in hospital for longer. We're testing a special breathing exercise to strengthen this muscle. It involves breathing against a resistance, similar to breathing through a straw. Our goal is to find the perfect level for this exercise — one that works the diaphragm well without causing distress or overworking other muscles. This could help patients breathe on their own more quickly, get home sooner, and avoid complications.

At a glance

Status
Recruiting
Sponsor
Royal Brompton & Harefield NHS Foundation Trust
Enrolment target
40
Start
23 Nov 2025
Estimated completion
01 Jan 2027

What is this study about?

When people are very unwell and in intensive care, they often need a machine to help them breathe. This is called a ventilator. While the ventilator helps, it can sometimes make the main breathing muscle, called the diaphragm, become weak. This weakness can mean patients stay on the ventilator and in hospital for a longer time, and might even lead to other health problems.

We know that special breathing exercises can help to strengthen the diaphragm. These exercises involve breathing through a small device that makes it a bit harder to breathe, like breathing through a straw. We call this 'inspiratory muscle training'. While these exercises sound promising, we need to find the best way to do them. Previous studies have shown that some breathing exercises haven't really helped patients come off the ventilator faster, possibly because they worked the wrong muscles or were uncomfortable.

Our study aims to find the 'just right' level of breathing exercise. We want to make sure it strengthens the diaphragm effectively without causing strain on other muscles in the chest and neck, or making patients feel uncomfortable or scared. By finding the ideal exercise level, we hope to help more patients get off the ventilator and return home more quickly and safely.

Key takeaways

  • This study aims to find the safest and most optimal breathing exercise intensity.
  • It focuses on strengthening the diaphragm, your main breathing muscle.
  • The goal is to help patients on ventilators breathe on their own faster.
  • Participation involves trying different breathing exercise levels and giving feedback.
  • This research could improve care for critically ill patients in the future.

Who may be eligible?

This study is looking for adults aged 18 or over who are currently in intensive care and need a breathing machine. To be part of this research, patients must also have a special breathing tube (tracheostomy) and be well enough to understand and take part in the breathing exercises. If a patient can't give their own permission, a family member or guardian can give it for them.

However, some people won't be able to join the study. This includes those with certain injuries, like face or skull fractures, or conditions that affect bleeding. Patients with certain lung problems, those who are pregnant, or if their doctor believes they are too unwell, won't be able to participate. Also, if a patient is too sleepy or confused to follow instructions, or has skin wounds where we need to place sensors, they won't be suitable for this study.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

  1. Are you 18 years old or older?
  2. Are you currently on a breathing machine and have a tracheostomy?
  3. Are you able to follow instructions and participate?
  4. Are you not pregnant?
  5. Do you not have certain facial injuries or bleeding problems?
  6. Are you not too unwell to participate according to your doctor?
Answer every question to see your result.

What does participation involve?

If you or your loved one takes part in this study, you will try different levels of breathing exercises. For each level, we will measure how hard your breathing muscles are working. This is done by gently placing a thin, soft tube into a nostril (which goes down to your throat) and by putting small sticky pads on your chest and neck. These measurements will tell us which breathing muscles are being used. After each exercise level, we will ask how you felt about it – for example, if it was easy, pleasant, or if it made you feel anxious. This whole process will be repeated one to three times over seven days, with at least a day between each session.

Potential risks and benefits

The potential benefit of taking part in this study is helping us find the most effective and comfortable breathing exercise level. This could eventually lead to better care for future patients, helping them come off ventilators sooner. There are some small risks, such as minor discomfort from the tube inserted into the nostril or from the sticky pads on the skin. We will also be asking about your feelings, which might be distressing for some. You have the right to withdraw from the study at any time, for any reason, without it affecting your medical care.

Locations (1)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.
  • Royal Brompton and Harefield Hospitals
    Verified postcode
    Marlow, United Kingdom· Recruiting

Common questions

What is a ventilator?

A ventilator is a machine that helps you breathe when you're too ill to breathe properly on your own. It pushes air into your lungs.

What is a tracheostomy?

A tracheostomy is a small opening made in the neck with a tube placed into your windpipe. It helps air get to your lungs, often when you need a ventilator.

What is the diaphragm?

The diaphragm is your main breathing muscle, located just beneath your lungs. It moves up and down to help you take breaths.

Will the breathing exercises hurt?

We aim to make the exercises as comfortable as possible. We will be asking for your feedback on how you feel during and after the exercises to make sure they are not too distressing.

Why do you need to measure my breathing muscles?

We measure your breathing muscles to see exactly which ones are working hard and to ensure the exercise effectively strengthens your diaphragm without overworking other muscles.

How to find out more

Always speak to your GP or specialist before deciding to take part in a study.

Interested in taking part?

Register your interest

Share your details and the research team for "Identifying the Optimal IMT Dose in ICU…" will contact you if you may be eligible. Always speak to your GP before agreeing to take part.

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