Critical Care Ultrasound Guided Weaning

Completed

• Conditions: Weaning Failure

• Registration Number: NCT05763134
• Lead Sponsor: Antalya Training and Research Hospital

Brief Summary

Weaning patients from the ventilator in the intensive care unit is sometimes difficult because of three main interrelated etiologies: impaired lung, heart or diaphragm function. In this context, ultrasonography performed during tests for extubation of patients may enable the diagnosis of cardiac dysfunction, loss of pulmonary aeration, diaphragm dysfunction, and venous congestion, thereby reducing the number of failures in extubation.

The combination of TTE (Trans Thoracic Echocardiography), LUS (Lung Ultrasound), DUS (Diaphragmatic ultrasound) and VEXUS (Venous excess Ultrasound) may enable the identification of the etiology of weaning failure and reduce the number of extubation failures by enabling the development of an appropriate treatment strategy. With this study, it is aimed to contribute to the literature in this sense.

Detailed Description

The aim of this study is to reduce the number of extubation failures by defining the etiology of weaning failure and developing appropriate treatment strategies by using intensive care ultrasonography applications in combination (defining cardiac, pulmonary, diaphragmatic and venous congestion).

Most patients can be extubated after the first SBT (spontaneous Breathing Trial). A patient who fails extubation is automatically classified as difficult weaning, and intensive care professionals frequently encounter patients who are difficult to wean from mechanical ventilation.

Before performing a new SBT following a failed SBT, the cause of the failure should be determined and an appropriate treatment strategy developed.

Study Timeline

• Status Verified: 2023-02
• Study First Submitted: 2023-02-28
• Study First Submitted QC: 2023-02-28
• Study Start: 2023-03-01
• Study First Posted: 2023-03-10
• Primary Completion: 2023-06-30
• Study Completion: 2023-07-20
• Last Update Submitted: 2023-07-20
• Last Update Posted: 2023-07-21

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 27

Inclusion Criteria

• Invasive mechanical ventilation > 24 hours Eligibility to weaning from mechanical ventilation

Exclusion Criteria

• Age < 18 years old
• Severe skin lesions or infections that cannot perform ultrasound
• Severe subcutaneous emphysema that cannot perform ultrasound
• Patients with a known neuromuscular disease
• Patients with a duration of mechanical ventilation <24 hours,
• Patients with severe mitral stenosis, severe mitral regurgitation, or prosthetic mitral valve

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Mechanical ventilation weaning success	48 hours	Weaning success: stable without mechanical ventilator support during more than 48 hours
Mechanical ventilation weaning failure	48 hours	Weaning failure: unstable without mechanical ventilator support within 48 hours

Secondary Outcome Measures

Name	Time	Method
Mortality	ICU mortality after ultrasonography guided weaning	Incidence of ICU mortality

Trial Locations

Locations (1)

Antalya Training and Research Hospital; 🇹🇷 Antalya, Turkey