Combined Thoracic Ultrasound Using Speckle Tracking for the Prediction of Weaning Failure : a Prospective Multicenter Study
Overview
- Phase
- Not Applicable
- Intervention
- echocardiography
- Conditions
- Weaning Failure of Mechanical Ventilation
- Sponsor
- Assistance Publique Hopitaux De Marseille
- Enrollment
- 110
- Locations
- 1
- Primary Endpoint
- lung and heart ultrasounds
- Status
- Recruiting
- Last Updated
- 2 months ago
Overview
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.
Investigators
Eligibility Criteria
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
Arms & Interventions
Resuscitation patients
Intervention: echocardiography
healthy volunteers
Intervention: echocardiography
Outcomes
Primary Outcomes
lung and heart ultrasounds
Time Frame: 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.