Critical Care Ultrasound Guided Weaning
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Weaning Failure
- Sponsor
- Antalya Training and Research Hospital
- Enrollment
- 27
- Locations
- 1
- Primary Endpoint
- Mechanical ventilation weaning success
- Status
- Completed
- Last Updated
- 2 years ago
Overview
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.
Investigators
Sule Asri
MD
Antalya Training and Research Hospital
Eligibility Criteria
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
Outcomes
Primary Outcomes
Mechanical ventilation weaning success
Time Frame: 48 hours
Weaning success: stable without mechanical ventilator support during more than 48 hours
Mechanical ventilation weaning failure
Time Frame: 48 hours
Weaning failure: unstable without mechanical ventilator support within 48 hours
Secondary Outcomes
- Mortality(ICU mortality after ultrasonography guided weaning)