Therapeutically Alternatives In Ventilator-Induced Diaphragm Dysfunction Critically Ill Patients
- Conditions
- Ventilator-Induced Diaphragmatic Dysfunction
- Interventions
- Device: Practice flow trigger sensitivity adjustment on mechanical ventilation for 1 week twice daily in addition to their plan of treatment.
- Registration Number
- NCT06515600
- Lead Sponsor
- South Valley University
- Brief Summary
The study is a prospective experimental study on adult patients admitted to the Critical Care Department in Qasr Al-Ainy. This study is conducted prospectively to assess the efficiency of trigger sensitivity adjustment on patients with ventilator-induced diaphragmatic dysfunction (VIDD).
- Detailed Description
The study is a prospective experimental study on adult patients admitted to the Critical Care Department in Qasr Al-Ainy. This study is conducted prospectively to assess the efficiency of trigger sensitivity adjustment on patients with ventilator-induced diaphragmatic dysfunction (VIDD).1. Flow Trigger: This type of trigger responds to the gas flow during inspiration. A flow trigger measures the rate of change of flow as the patient begins to inhale. When the flow reaches a certain threshold, the ventilator is triggered to deliver a breath.
1. Laboratory investigations: Arterial blood gases (ABG):- (PH, PCO2, HCO3, and PO2) after the session.
2. Ventilator Parameters:( a) Minute Ventilation, b) Tidal Volume, c) Rapid Shallow breathing index, d) Negative Inspiratory Force (NIF) will be measured pre and post-treatment
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 30
- Patients who had undergone MV for 48 hours or more in a controlled mode.
- Patients could not generate maximum inspiratory pressure of more than 15 mbar
- Patients had diaphragmatic excursion less than 3 cm. (normal level from 3 to 5 cm.)(It can increase in a condition person to 7-8 cm).
- Patients had a diaphragmatic thickness fraction of less than 30%
- Patients with comorbidities interfering and compromising weaning like cardiac arrhythmia, pericardial effusion, congestive heart failure, or unstable acute coronary syndrome.
- Patients who had inadequate training performance of the inspiratory muscle such as those having myopathy or neuropathy.
- Patients hemodynamically unstable.
- Patients who had a major neurological deficit.
- Sedated Patients.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Study group Practice flow trigger sensitivity adjustment on mechanical ventilation for 1 week twice daily in addition to their plan of treatment. Group (A) (study group) will include 30 patients who practiced flow trigger sensitivity adjustment on mechanical ventilation for 1 week twice daily in addition to their plan of treatment. Controlled group Practice flow trigger sensitivity adjustment on mechanical ventilation for 1 week twice daily in addition to their plan of treatment. Group (B) (controlled group) will include 30 patients who received their routine plan of weaning of mechanical ventilator (controlled mode then spontaneous mode and finally spontaneous breathing trial).
- Primary Outcome Measures
Name Time Method HCO3 mEQ/Liter one week HCO3 mEQ/Liter
Arterial blood gases (ABG):- one week PH
PCO2 mmHg one week PCO2 mmHg
PSAO2 mmHg one week PSAO2 mmHg
Vital signs one week Heart Rate (HR) b/min
Respiratory rate RR/min one week Respiratory rate RR/min
Blood Pressure mmHg one week Blood Pressure mmHg
- Secondary Outcome Measures
Name Time Method Tidal Volume L/breath one week Tidal Volume L/breath
Ventilator parameters one week Minute Ventilation L/min