Combination of respiratory muscle strength, P0.1 and lung ultrasound score to predict weaning failure from mechanical ventilation in critically ill patients: A prospective observational study.
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 149
- 试验地点
- 1
- 主要终点
- To assess the power of the Combination of respiratory muscle strength, P0.1 and
研究概览
简要总结
This thesis focuses on predicting weaning failure from mechanical ventilation in critically ill patients using a combination of respiratory muscle strength, airway occlusion pressure at 100 milliseconds (P0.1), and lung ultrasound score (LUS). Weaning from mechanical ventilation is a critical process in intensive care units (ICUs), where both premature and delayed extubation can lead to serious complications, including diaphragm dysfunction, ventilator-associated pneumonia, and airway trauma.
The study builds on prior research that has established the utility of different physiological markers in predicting weaning outcomes. The LUS, developed by Bouhemad et al., assesses lung aeration and has been shown to be an effective predictor of post-extubation distress. Similarly, diaphragmatic thickness and thickening fraction (DTF) have been linked to successful weaning. The P0.1 index, which measures central respiratory drive, has also been found to predict extubation success.
This observational study, conducted in a critical care unit, aims to integrate these parameters to improve the accuracy of weaning predictions. It involves assessing patients undergoing spontaneous breathing trials (SBT) through bedside ultrasonography, lung ultrasound, and respiratory drive monitoring. The study population includes critically ill patients eligible for weaning after at least 48 hours of mechanical ventilation, with specific inclusion and exclusion criteria to ensure valid results.
The methodology involves measuring LUS, diaphragmatic and intercostal muscle thickness, and P0.1 during the SBT, followed by statistical analysis to determine their predictive power. Ethical considerations include obtaining informed consent and ensuring patient safety.
The expected outcome is that the combined assessment of these physiological markers will provide a more reliable predictor for weaning success, reducing re-intubation rates and improving patient outcomes in the ICU.
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 18.00 Year(s) 至 99.00 Year(s)（—）
- 性别
- All
入选标准
- •Patient eligible for SBT after 48 hrs of mechanical ventilation in CCU Positive end-expiratory pressure less than or equal to 6 cm H2O Partial Pressure of Arterial Oxygen more than or equal to 60 mmHg with fraction of inspired oxygen less than 0.45 GCS more than 13 Richmond Agitation Sedation Scale -1 to +1 Body Temperature less than 38 degree Celsius Hematocrit level more than 21% or Hemoglobin level more than 7 g/dL No or low doses of vasopressor support.
排除标准
- •Patients with difficulty in obtaining ultrasound window Mechanical Ventilation less than 48 hrs History of Diaphragmatic Paralysis or Injury Ascites Thoracotomy Pneumothorax Pleural Effusion Thoracic Trauma History of Neuromuscular Disease Pregnant women Lactating or nursing mothers.
结局指标
主要结局
To assess the power of the Combination of respiratory muscle strength, P0.1 and
时间窗: 30 mins after Spontaneous Breathing Trial
lung ultrasound score will predict weaning failure from mechanical ventilation in
时间窗: 30 mins after Spontaneous Breathing Trial
critically ill patients.
时间窗: 30 mins after Spontaneous Breathing Trial
次要结局
- To assess Extubation failure(Upto 48 hours after extubation)
- Requirement of noninvasive respiratory support after extubation(Upto 48 hours after extubation)
研究者
Jadav Sainath
Department of anaesthesiology and critical care AIIMS Raipur