Critical Care Ultrasound Guided Weaning
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 27
- 试验地点
- 1
- 主要终点
- Mechanical ventilation weaning success
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 85 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Invasive mechanical ventilation > 24 hours Eligibility to weaning from mechanical ventilation
排除标准
- •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
结局指标
主要结局
Mechanical ventilation weaning success
时间窗: 48 hours
Weaning success: stable without mechanical ventilator support during more than 48 hours
Mechanical ventilation weaning failure
时间窗: 48 hours
Weaning failure: unstable without mechanical ventilator support within 48 hours
次要结局
- Mortality(ICU mortality after ultrasonography guided weaning)
研究者
Sule Asri
MD
Antalya Training and Research Hospital