Effectiveness of the Ratio of Respiratory Rate to Diaphragm Thickening Fraction in Predicting Successful Extubation
Trial Snapshot
- Phase
- Not Applicable
- Status
- Active, not recruiting
- Sponsor
- Enrollment
- 140
- Locations
- 2
- Primary Endpoint
- assessing the diagnostic accuracy of the respiratory rate/diaphragmatic thickening fraction that is measured by diaphragmatic ultrasound in predicting successful extubation from mechanical ventilation
Study Overview
Brief Summary
the aim of this prospective cross-sectional study is Assessment the effectiveness of the RR/DTF in predicting successful extubation . and to Compare the effectiveness of the RR/DTF with conventional parameters (RSBI, VC, PIMAX) for predicting successful extubation
All participants will undergo a SBT by using pressure support ventilation (PSV) with pressure support of 5 cm H2O and positive end-expiratory pressure (PEEP) of 5 cm water (H2O) .
The decision to start weaning, extubation or reintubation will be made based on the attending physician's discretion following local guidelines. Daily, patients will be assessed by the attending physician for weaning readiness. Investigators will be informed when the ICU attending decide to extubate.
Detailed Description
this study will be carried out on mechanically ventilated patients in medical and surgical intensive care units (ICU) at Banha University Hospitals.
Each Patient after taking an informed consent will be subjected to:
- Full history taking including:
Personal, present, past, family, and surgical histories of the patients will be documented. This includes collecting information about the patient's demographics, current health status, medical history, family medical history, length of mechanical ventilation(MV) until SBT, underlying disease, cause of respiratory failure and any prior surgical procedures. 2. Clinical Examination:
A thorough clinical examination of the patients will be conducted to evaluate their general health and assess any physical signs and symptoms related to the cause of admission or other conditions. Respiratory rate will be examined as well. 3. Laboratory Investigations:
Study Design
- Study Type
- Observational
- Observational Model
- Other
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age > 18 years old.
- •Both sexes will be included.
- •Patients with acute respiratory failure caused by medical or postoperative conditions who had been receiving MV for more than 48 h and tolerated 2 h spontaneous breathing trial (SBT)
- •Readiness for weaning from MV (recovery from the cause of respiratory failure, hemodynamic stability in the absence of vasopressors, and no administration of neuromuscular blocking agents or sedative drugs for more than 24 h prior to enrollment).
Exclusion Criteria
- •History of neuromuscular disease or thoracic surgery.
- •Pneumothorax.
- •Presence of ascites.
- •Tracheostomized patients.
- •Poor image quality.
- •Spinal cord injury.
- •Arrhythmias.
- •Hemodynamic instability.
Outcomes
Primary Outcomes
assessing the diagnostic accuracy of the respiratory rate/diaphragmatic thickening fraction that is measured by diaphragmatic ultrasound in predicting successful extubation from mechanical ventilation
Time Frame: 2 years
• The diaphragm thickening fraction (DTF) will be measured by using linear probe at the anterior axillary line with the transducer placed at the intercostal space between the 7th and 8th, or 8th and 9th ribs.Then (DTF) percentage will be calculated with the following formula: thickness at the end of inspiration minus thickness at the end of expiration,divided by thickness at the end of expiration, then multiplied by 100. The RR/DTF will be calculated by dividing the respiratory rate (RR) by the DTF.
Secondary Outcomes
No secondary outcomes reported
Investigators
Eman Diaa ElDin Hassan AlHassanin
principal investigator
Benha University