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Updated: Oct 15, 2026

Inspiratory Muscle Training as an Adjunct to the Treatment of Weaning Failure in Critically Ill Patients: A Practical Guide
Published on: January 30, 2026
Hypercapnic respiratory failure during weaning: neuromuscular capacity versus muscle loads
1Associate Professor, Division of Pulmonary and Critical Care Medicine, Edward Hines Jr Veterans Affairs Hospital, Hines, IL 60141, USA.
Abstract:
Patients who fail a weaning trial develop hypercapnia as a result of alveolar hypoventilation, which, in turn, is caused by an imbalance between the respiratory muscle load and capacity. In some patients, especially those with obstructive lung diseases, respiratory muscle performance is impaired as a result of dynamic hyperinflation and paradoxical motion of the rib cage and abdomen. Worsening of pulmonary mechanics causes further embarrassment of the respiratory muscles and can lead to marked alterations of oxygen use by the peripheral tissues. The development of rapid shallow breathing together with worsening of pulmonary mechanics results in inefficient clearance of COcf152cf1 during a failed weaning attempt.
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