Speckle Tracking Echocardiography for the Prediction of Weaning Failure

Not Applicable

• Conditions: Weaning Failure of Mechanical Ventilation
• Interventions: Other: echocardiography

• Registration Number: NCT03657524
• Lead Sponsor: Assistance Publique Hopitaux De Marseille

Brief Summary

Deciding the optimal timing for extubation in patients who are mechanically ventilated can be challenging, and traditional weaning predictor tools are not accurate. Recent studies suggest that isolated sonographic assessment of the respiratory and cardiac function (ie diastolic function and filling pressure), in mechanically ventilated patients may assist in identifying patients at risk of weaning failure. Recently, the association of conventional echocardiography and lung ultrasound showed promising results for the prediction of post extubation distress. Speckle Tracking is an emerging tool in intensive care medicine that has never been investiguated for the prediction of weaning failure. It could early detects diastolic dysfunction and and elevated filling pressure. Of more, speckle tracking is known to be less operator dependant. The main objective of our study is to evaluate the diagnosis accuracy of speckle tracking echocardiography performed during a weaning trial to predict weaning failure. The secondary objectives are to assess the diagnosis accuracy of combined heart and lung ultrasound to predict weaning failure.

Detailed Description

Deciding the optimal timing for extubation in patients who are mechanically ventilated can be challenging, and traditional weaning predictor tools are not accurate. Recent studies suggest that isolated sonographic assessment of the respiratory and cardiac function (ie diastolic function and filling pressure), in mechanically ventilated patients may assist in identifying patients at risk of weaning failure. Recently, the association of conventional echocardiography and lung ultrasound showed promising results for the prediction of post extubation distress. Speckle Tracking is an emerging tool in intensive care medicine that has never been investiguated for the prediction of weaning failure. It could early detects diastolic dysfunction and and elevated filling pressure. Of more, speckle tracking is known to be less operator dependant. The main objective of our study is to evaluate the diagnosis accuracy of speckle tracking echocardiography performed during a weaning trial to predict weaning failure. The secondary objectives are to assess the diagnosis accuracy of combined heart and lung ultrasound to predict weaning failure.

Study Timeline

• Status Verified: 2018-08
• Study First Submitted: 2018-08-31
• Study First Submitted QC: 2018-09-04
• Last Update Submitted: 2018-09-04
• Study First Posted: 2018-09-05
• Last Update Posted: 2018-09-05
• Study Start: 2018-11-02
• Primary Completion: 2019-11-02
• Study Completion: 2021-11-02

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 110

Inclusion Criteria

• Patients hospitalized in intensive care unit under mechanical fulfilling the criteria of ventilation weaning trial.

Exclusion Criteria

• Less than 18 years old.
• Pregnancy
• Non sinusal cardiac rhythm
• Neuro Myopathy
• Tracheotomy
• Lack of echogenicity to perform at least a four chamber apical view

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
healthy volunteers	echocardiography	-
Resuscitation patients	echocardiography	-

Primary Outcome Measures

Name	Time	Method
lung and heart ultrasounds	Just before and during the weaning trial	Area under the receiver operator characteristic curve (AUC) of global longitudinal strain and strain rate variations (before and during a weaning trial) to predict weaning failure.

Trial Locations

Locations (1)

Assistance Publique Hôpitaux de Marseille; 🇫🇷 Marseille, France