Use of ultrasound to see if patients who have undergone neurosurgery can breathe on their own without ventilator support

Completed

• Conditions: Medical and Surgical,

• Registration Number: CTRI/2023/04/051374
• Lead Sponsor: Govind Ballabh Pant Institute of Post graduate Medical Education and Research Institute

Brief Summary

This study aims to analyse the predictability of ultrasound-based parameters of lung, diaphragm and heart for the weaning outcome in postoperative mechanically ventilated neurosurgical patients who are on mechanical ventilation for >24 hr. After assessing the eligibility for initiating weaning process by Weaning Clinical Criteria, the patients will be subjected to **Spontaneous Breathing Trial (SBT)**which isspontaneous breathing through a T-tube circuit with oxygen flow at 5 L/min for 60 min. Patients who tolerate 60 mins of SBT will be continued on spontaneous breathing and will be observed for 48 hours thereafter for requirement of ventilatory support. They will be considered to have been successfully weaned if they do not require ventilatory support. Others who do not tolerate SBT would be connected back to ventilator and considered to have failed weaning. Ultrasound examination will be performed at **5 min and 30** **min** of start of SBT to assess  a) Diaphragmatic thickening fraction, b) Diaphragmatic excursion, c) Lung ultrasound score, d) Left ventricular diastolic function. Weaning Outcome (Success/ Failure) will be decided on the basis of result of SBT.

Detailed Description

Not available

Study Timeline

• Study Start: 2023-04-20
• Last Update Posted: 2023-05-04
• Study Completion: 2024-10-04

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 75

Inclusion Criteria

All patients, 18 to 65 years of age who have undergone neurosurgical procedure, and are on mechanical ventilation for more than 24 hours post operatively and are ready for weaning (based on Weaning Clinical Criteria) will be included in this study.

Exclusion Criteria

1)preoperatively patients who are on respiratory support for more than 24 hours (either intermittent or continuous oxygen therapy/ invasive or non-invasive mechanical ventilation) 2)patients with heart diseases like severe valvular heart diseases, severe left ventricular dysfunction ( EF<30%), heart failure, etc 3)patients who have undergone thoracic surgeries like pneumonectomy, pleurodesis, and thoracic trauma 4)pregnancy.

Study & Design

• Study Type: Observational
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
2.Diaphragmatic excursion (DE)	USG examination will be performed at 5 min and 30 min of start of Spontaneous Breathing Trial
3.Lung ultrasound score (LUS)	USG examination will be performed at 5 min and 30 min of start of Spontaneous Breathing Trial
1.Diaphragmatic thickening fraction (DTF)	USG examination will be performed at 5 min and 30 min of start of Spontaneous Breathing Trial
4.Left ventricular (LV) diastolic function- E/A ratio	USG examination will be performed at 5 min and 30 min of start of Spontaneous Breathing Trial

Trial Locations

Locations (1)

Govind Ballabh Pant Institute of Postgraduate Medical Education and Reaserch Institute; 🇮🇳 Central, DELHI, India

Govind Ballabh Pant Institute of Postgraduate Medical Education and Reaserch Institute

🇮🇳Central, DELHI, India

Bhavani B

Principal investigator

9840494620

swathabhavani@gmail.com