The aim of the current study is to compare the effect of ventilator trigger sensitivity adjustment versus threshold inspiratory muscle training on arterial blood gases in mechanically ventilated patients.
Difficult to wean Guillain barre patients who have been on MV for at least 48 hours. Difficult to wean subjects have been defined as those who fail the first spontaneous breathing trial (SBT)and may require up to 3 SBTs or up to 7 d from the first attempt to achieve successful weaning (B´eduneau G. et al.,2017) and (Annia F. et al.,2019).
Age: >18 years.
Both sexes will be included.
Ventilator mode: Pressure support mode with FiO2≤ 0.5, positive end expiratory pressure (PEEP) will be<8-10cm/H2Oand respiratory rate < 25.
Persistent hemodynamic instability as life threatening arrhythmias, acute heart failure.
Severe breathlessness, when spontaneously breathing.
Any progressive neuromuscular disease that would interfere with responding to inspiratory muscle training (non-stationary course).
Spinal cord injury.