Role of Ultrasound Assessment of Parasternal Intercostal Muscle Thickness During Weaning From Mechanical Ventilation

• Conditions: Parasternal Intercostal Muscle Thickness; Weaning From Mechanical Ventilation
• Interventions: Diagnostic Test: Parasternal intercostal muscles thickness ultrasound indicies

• Registration Number: NCT04779463
• Lead Sponsor: Wesameldin Abelrahman Soltan

Brief Summary

Assessment of the the parasternal intercostal muscles thickness by the ultrasonography as a weaning predictor of the mechanically ventilated patients

Detailed Description

impact of parasternal muscle thickness on the weaning process of the mechanically ventilated patients in ICU

Study Timeline

• Study Start: 2020-06-01
• Status Verified: 2021-02
• Study First Submitted: 2021-02-27
• Study First Submitted QC: 2021-02-27
• Last Update Submitted: 2021-02-27
• Primary Completion: 2021-03-01
• Study First Posted: 2021-03-03
• Last Update Posted: 2021-03-03
• Study Completion: 2021-04-01

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

Any patient invasively mechanically ventilated at least 24 hours on a pressure support mode who is clinically stable and ready to undergo a spontaneous breathing trial.

All patients will be:

• Alert.
• Afebrile.
• Adequate cough with absence of excessive tracheobronchial secretion.
• Fraction of inspired oxygen (FIO2) of <50%.
• PEEP ≤8 cmH2O.
• PaO2/FiO2 > 150.
• pH ≥7.35 and ≤7.45.
• Respiratory rate (RR) ≤35 breaths/min.
• Hemodynamically stable in the absence of vasopressors.
• Stable metabolic and endocrinal status.
• Euglycemic state.
• Adequate mentation (no sedation or stable neurologic patient).

Exclusion Criteria

Diaphragmatic paralysis (detected by ultrasonography).Patients&Methods. 6

• Pregnant women.
• Age: >= 18 years.
• Surgical dressings over measurement point which would preclude ultrasound exam.
• Underweight patients (Body mass index <18.5 kg/m2).
• Morbidly obese patient (Body mass index ≥ 40 kg/m2).
• Primary neuro-muscular diseases.
• Central coditions with depressed central respiratory drive (encephalitis, and brainstem haemorrhage/ischaemia).
• Repiratory conditions with reduced pulmonary compliance (interstitial lung disease, pulmonary hemorrhage, and diffuse pulmonary infiltrates) or reduced chest wall compliance (kyphoscoliosis).
• Cardiac conditions with high risk of weaning induced pulmonary edema (congestive heart failure, cyanotic heart diease, pulmonary hypertension, and ischemic heart diease).
• Addict patients.
• Patients with psychiatric disease.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Mechanical Ventilated patients	Parasternal intercostal muscles thickness ultrasound indicies	All patients are invasively mechanically ventilated at least 24 hours, and are clinically stable as ready to undergo a spontaneous breathing trial.

Primary Outcome Measures

Name	Time	Method
the thickness fraction of the parasternal intercostal muscle as a predictor of successful spontaneous breathing trials	Before the start spontaneous breathing trial	The primary outcome is to assess the change of the parasternal intercostal muscles thickness at end of expiration and end of inspiration to verify the thickness fraction of the parasternal intercostal muscle as a predictor of successful spontaneous breathing trials.

Trial Locations

Locations (1)

Faculty of Medicine - Menoufia University; 🇪🇬 Shibīn Al Kawm, Menoufia, Egypt