Diaphragmatic Atrophy Related to Mechanical Ventilation
- Conditions
- Septic ShockAcute Respiratory Distress
- Registration Number
- NCT02766946
- Lead Sponsor
- Centre Hospitalier Saint Joseph Saint Luc de Lyon
- Brief Summary
Ventilatory support during critical phase result in inactivity of respiratory muscles especially diaphragm muscle. These inactivity also result in change of contractile capability and quick muscular atrophy.
The aim of the study is to visualize the evolution of diaphragm thickness by echography during Mechanical Ventilation for patients with septic shock or acute respiratory distress syndrome and to compare with the evolution for patients under non-invasive ventilation and those with spontaneous ventilation. Measurements will be performed at day 1, day 5 and day 10 (if patient still under a mode of ventilation or in the unit).
The evolution of diaphragm thickness will also be compared to pectoralis muscle atrophy, which is not involved in ventilation, in order to assess respective effect of ventilatory inactivity and undernutrition linked to intensive care.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 97
- Age ≥18 years old
- Group 1 : under Mechanical Ventilation (time of Mechanical Ventilation for at least 5 days)
- Group 2 : under Non-invasive Ventilation
- Group 3 : Spontaneous Ventilation
- Non opposition of patient (Groups 2 and 3) or non-opposition of patient family member (Group 1)
- Known diaphragmatic paralysis
- Neurologic pathology with motor deficit
- Pregnancy or breast-feeding woman
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Primary Outcome Measures
Name Time Method Change from day 1 diaphragm thickness at day 3 and day 5 1 day, 3 days and 5 days after introduction of Mechanical Ventilation Diaphragm thickness measured by ultrasound
- Secondary Outcome Measures
Name Time Method Diaphragm thickness measured by ultrasound 10 days after introduction of Mechanical Ventilation Type of ventilatory support 10 days after start of ventilatory support Define which type of ventilatory support is used (mechanical ventilation, non-invasive ventilation, or spontaneous ventilation)
Ventilatory mode 10 days after start of ventilatory support Ventilatory mode (controlled ventilation, pressure support ventilation)
Diaphragmatic strength intraoperative Relation between diaphragmatic atrophy and decrease of diaphragmatic strength
MRC score (Medical Research Council) intraoperative Relation between diaphragmatic atrophy and decrease of diaphragmatic strength
Respiratory rate 10 days after start of ventilatory support Highest inspiratory pressure level 10 days after start of ventilatory support Pectoralis muscle thickness measured by ultrasound 10 days after start of ventilatory support To compare the importance of this atrophy to those of diaphragmatic muscle
Early or late extubation failure rate (extubation performed before or after 48 hours) The last day of hospitalisation Relation between diaphragmatic atrophy importance and premature (\<48h) or late extubation failure
Length of ventilation in hours 10 days after start of ventilatory support Drug administration 10 days after start of ventilatory support Presence of drug administration such as curare, corticoid or sedative. If yes : number of days with treatment
Total positive end expiratory pressure 10 days after start of ventilatory support Highest expiratory pressure level 10 days after start of ventilatory support External positive end expiratory pressure 10 days after start of ventilatory support Volume of exhaled air 10 days after start of ventilatory support