Clinical Research Directory

Inclusion Criteria: * Acute respiratory failure patients in the ICU are receiving MV for 48 h or more in a controlled mode. * Their ages will range from 40 to 55 years old, and both sexes will be included. * Conscious and oriented patients with a Glasgow coma score ≥13 (≥9T). * Alertness score with a Richmond Agitation-Sedation Scale (RASS) will be from 0 to -1. * All patients in this study must be hemodynamically and medically stable. * Patients must be able to trigger spontaneous breaths on the ventilator but couldn't generate maximum inspiratory pressure more than -15 mbar. Exclusion Criteria: * Persistent hemodynamic instability as life-threatening conditions or comorbidities interfere with and compromise weaning, like cardiac arrhythmia, pericardial effusion, congestive heart failure, or acute coronary syndrome. * Severe breathlessness when spontaneously breathing. * Any progressive neuromuscular disease, such as myopathy or neuropathy, that would interfere with responding to inspiratory muscle training due to inadequate training performance of the inspiratory muscle. * Spinal cord injury. * Skeletal pathology (scoliosis, flail chest, spinal instrumentation) that would seriously impair the movement of the chest wall and ribs. * Patients in a coma or under heavy sedation (RASS ≤ -2) and with respiratory muscle paralysis. * High peak airway pressure (barotrauma), high PEEP \>10, or active pneumothorax.