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Enrolling by invitationNCT07761468UTIT-IMTUpdated Aug 12, 2026

Standardization of IMT Dosage (UTIT) in Mechanical Ventilation.

An interventional study of Inspiratory Muscle Training (IMT) in Ventilator Induced Diaphragm Dysfunction, Respiratory Muscle Weakness and Mechanical Ventilation Weaning, sponsored by Hospital H+ Queretaro. Enrolling by invitation at 1 site in Mexico. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-12.

Sponsored by Hospital H+ Queretaro · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
60
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Respiratory muscle weakness prolongs mechanical ventilation (MV) and delays weaning. Currently, there is no standardized dosage for Inspiratory Muscle Training (IMT) in the ICU. This study aims to define an optimal IMT dosage using a new metric called "Total Inspiratory Work Unit" (UTIT), which integrates intensity, repetition, and frequency.

The study compares three daily dosage regimens (1,000 UTIT, 2,000 UTIT, and 3,000 UTIT) adjusted daily based on the patient's Negative Inspiratory Force (NIF). The goal is to determine the optimal dose-response relationship for improving inspiratory muscle strength (PiMax) and reducing the duration of mechanical ventilation.

Read the detailed description

This is a randomized clinical trial conducted at Hospital H+ Querétaro. Eligible intubated patients will be assigned to one of three intervention groups differing in the daily volume of inspiratory work.

The "Total Inspiratory Work Unit" (UTIT) is defined as: UTIT = (Target NIF %) x (Number of Breaths per Session) x (Number of Sessions per Day).

Intensity is adjusted daily to maintain the target UTIT dose. The study utilizes a threshold loading device (POWERbreathe K5) with real-time feedback. Safety parameters (SpO2, HR, FR, MAP) are monitored continuously during sessions. The intervention continues until successful weaning, extubation, ICU discharge, or death.

02

Conditions studied

  • Ventilator Induced Diaphragm Dysfunction
  • Respiratory Muscle Weakness
  • Mechanical Ventilation Weaning

Keywords

  • Inspiratory Muscle Training
  • Intensive Care Unit
  • Total Inspiratory Work Unit (TIWU)
  • Negative Inspiratory Force (NIF)
  • Mechanical Ventilation
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Adult patients (>18 years of age) admitted to the Intensive Care Unit (ICU).
  • Invasive mechanical ventilation support for more than 48-72 hours.
  • Hemodynamic stability (defined as absence of vasopressors or receiving stable doses).
  • Adequate oxygenation and ventilatory parameters: PEEP \< 10 cmH2O, FiO2 \< 0.6, and PaO2/FiO2 ratio > 150-200.
  • Ability to cooperate with instructions or absence of deep sedation.

Exclusion criteria

Exclusion Criteria:

  • Pre-existing neuromuscular pathology directly affecting respiratory muscles.
  • Severe thoracic trauma or recent thoracic surgery.
  • Unresolved pneumothorax or bronchopleural fistula.
  • Severe hemodynamic instability or severe cardiac arrhythmias.
  • Level of sedation that prevents active participation in sessions.
  • Pregnancy
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
60 participants (estimated)

Study arms

  • Experimental
    Low Dose Group (1,000 UTIT)

    Participants receive a daily IMT dosage of 1,000 Total Inspiratory Work Units (UTIT). Intensity: 30% of the patient's baseline Negative Inspiratory Force (NIF). Repetitions: 30 breaths per session. Frequency: 1 session per day

    Procedure: Inspiratory Muscle Training (IMT)

  • Experimental
    Intermediate Dose Group (2,000 UTIT)

    Participants receive a daily IMT dosage of 2,000 Total Inspiratory Work Units (UTIT). Intensity: 50% of the patient's baseline Negative Inspiratory Force (NIF). Repetitions: 60 breaths per session. Frequency: 2 sessions per day.

    Procedure: Inspiratory Muscle Training (IMT)

  • Experimental
    High Dose Group (3,000 UTIT)

    Participants receive a daily IMT dosage of 3,000 Total Inspiratory Work Units (UTIT). Intensity: 80% of the patient's baseline Negative Inspiratory Force (NIF). Repetitions: 60 breaths per session. Frequency: 3 sessions per day.

    Procedure: Inspiratory Muscle Training (IMT)

Interventions

  • ProcedureInspiratory Muscle Training (IMT)

    Respiratory rehabilitation training using a specific threshold loading device (POWERbreathe K5) with real-time feedback. The intervention aims to strengthen inspiratory muscles (diaphragm and intercostals). The daily dosage is calculated using the Total Inspiratory Work Unit (UTIT) formula, adjusted daily based on the patient's Negative Inspiratory Force (NIF).

05

What researchers measure

Primary outcomes

  1. Change in Maximal Inspiratory Pressure (Pimax)

    Change in maximal inspiratory pressure measured in cmH₂O using the POWERbreathe K5 device to evaluate inspiratory muscle strength from baseline to the end of the intervention.

    Time frame: From baseline (study entry) up to successful weaning, extubation, or ICU discharge (up to 30 days).

  2. Total Duration of Mechanical Ventilation

    Total number of consecutive days a patient requires invasive mechanical ventilation support via endotracheal tube.

    Time frame: From the initiation of mechanical ventilation until successful extubation or ICU discharge (up to 30 days)

Secondary outcomes

  1. Duration of the Weaning Process

    Number of days from the first spontaneous breathing trial (SBT) or initiation of weaning protocol until successful extubation

    Time frame: From the start of the weaning process up to successful extubation (up to 30 days)

  2. Reintubation Rate Within 72 Hours

    Percentage of patients who require reintubation within 72 hours following initial planned extubation.

    Time frame: Within 72 hours post-extubation

  3. Length of Stay in Intensive Care Unit (ICU)

    Total number of days the patient remains admitted to the ICU.

    Time frame: From study enrollment until ICU discharge (up to 30 days).

06

Study locations

1 site
  • Hospital H+ Querétaro, Santiago de Querétaro, Querétaro
    Querétaro City, Querétaro 76000, Mexico
07

Registry details

Key details

Study ID
NCT07761468
Lead sponsor
Hospital H+ Queretaro
Responsible party
Jose J Zaragoza, MD MSc (Principal Investigator, Hospital H+ Queretaro) — Principal investigator
First posted
Aug 12, 2026
Start date
Aug 1, 2025
Primary completion
Aug 30, 2026 (estimated)
Completion
Nov 1, 2026 (estimated)
Last update
Aug 12, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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