Evaluation of Diaphragmatic Displacement During Spontaneous Breathing Trials in Critically Ill Patients
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Respiratory Failure
- Sponsor
- Università degli Studi di Ferrara
- Enrollment
- 44
- Locations
- 1
- Primary Endpoint
- Weaning success
- Status
- Completed
- Last Updated
- 10 years ago
Overview
Brief Summary
Acute respiratory failure (ARF) is characterised by a discrepancy between load imposed on respiratory muscles and their capacity. Recently, diaphragmatic ultrasonography has been introduced in the clinical practice to evaluate diaphragmatic function. In particular, the investigators will focus on Diaphragmatic Displacement measured by M-mode ultrasonography. The aim of this study was to compare the diaphragmatic displacement with traditional weaning parameters in potentially ready to be extubated patients undergoing a spontaneous breathing trial (SBT).
Investigators
Savino Spadaro
Dr
Università degli Studi di Ferrara
Eligibility Criteria
Inclusion Criteria
- •mechanically ventilated since more than 24 hours
- •clinical improvement of the underlying acute cause of the respiratory failure
- •adequate cough reflex
- •absence of excessive and/or purulent tracheobronchial secretion
- •stable cardiovascular status
- •stable metabolic status
- •adequate pulmonary function
- •adequate mentation
Exclusion Criteria
- •age \<18 years
- •pregnancy
- •presence of thoracostomy, pneumothorax or pneumomediastinum
- •presence of flail chest or rib fractures
- •neuromuscular disease
- •use of muscle-paralyzing agents within 48 hours before the study
- •history or new detection of paralysis or paradoxical movement of a single hemi-diaphragm on diaphragm ultrasonography
Outcomes
Primary Outcomes
Weaning success
Time Frame: within the first 48 hours after the spontaneous breathing trial
A successful weaning attempt was registered when patients were extubated and breathed spontaneously for more than 48 hours. The reinstitution of mechanical ventilation at the end of spontaneous breathing trial, reintubation within 48 hours or non-invasive ventilation (NIV) support after extubation defined a failed weaning attempt.