Comparison of removal of a patient from ventilator by giving external positive pressure before disconnecting and removing the endotracheal tube with the traditional method of endotracheal tube removal without giving external positive pressure in Critically Ill Patients
- Conditions
- Health Condition 1: - Health Condition 2: O- Medical and Surgical
- Registration Number
- CTRI/2020/02/023166
- Lead Sponsor
- ALL INDIA INSTITUTE OF MEDICAL SCIENCES NEW DELHI
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Completed
- Sex
- Not specified
- Target Recruitment
- 70
Patients mechanically ventilated with an endotracheal tube for at least 72 hours
Patients deemed fit for extubation by the following criteria or by the physicians discretion
PaO2 greater than or equal to 60 mm Hg on FIO2 lesser than or equal to 50 percentage
SaO2 greater than or equal to 90% on FIO2 lesser than or equal to 50 percentage
pH greater than or equal to 7.32 or a decrease in pH less than 0.07 from baseline of SBT
Rapid shallow breathing index less than 105 breaths per min per Litre
Respiratory rate less than or equal to 35 breaths per min or increase less than 50 percentage from baseline of SBT
Hemodynamically stable patient
Successful T-piece or Pressure support ventilation trial for 30 minutes
Patients planned in advance to be extubated directly to NIV or High flow nasal cannula
Patients with severe asthma bullous lung disease or severe emphysematous lung disease
Patients with suspected raised ICP
Patients with a poor GCS of less than 8
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Comparison of lung aeration of patients who undergo traditional extubation with those undergoing positive pressure extubation using lung ultrasound.Timepoint: End of SBT <br/ ><br>30 Mins Post Extubation <br/ ><br>6 Hours Post Extubation <br/ ><br>24 Hours Post Extubation
- Secondary Outcome Measures
Name Time Method Change in lung ultrasound scores pre and post extubation in the two groupsTimepoint: End of SBT <br/ ><br>30 Mins Post Extubation <br/ ><br>6 Hours Post Extubation <br/ ><br>24 Hours Post Extubation;Change in the A-aO2 gradient pre and post extubation in the two groupsTimepoint: End Of SBT <br/ ><br>1 Hour Post Extubation;Chest X-ray findings between the two groupsTimepoint: Before Extubation <br/ ><br>24 Hours Post Extubation;ICU free days and Reintubation rates between the two groupsTimepoint: ICU free days at 28 days <br/ ><br>Reintubation rates at 72 hours and 28 days;Incidence of adverse clinical events between the two groupsTimepoint: Extubation failure within 48 hours <br/ ><br>Desaturation within 48 hours <br/ ><br>New onset bronchospasm within 48 hours <br/ ><br>Tachypnea within 30 minutes <br/ ><br>Tachycardia within 30 minutes <br/ ><br>Hypertension within 30 minutes <br/ ><br>Pneumonia within 48 hours <br/ ><br>