The Role of Diaphragmatic Ultrasound as a Predictor of Successful Extubation From Mechanical Ventilation in Respiratory Intensive Care Unit
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 120
- 试验地点
- 1
- 主要终点
- diaphragmatic ultrasound thickening
研究概览
简要总结
Aim: To evaluate real-time ultrasound in the evaluation of diaphragmatic thickening, thickening fraction and or excursion to predict extubation outcomes. The investigators aimed to compare these parameters with other traditional weaning measures.
详细描述
The diaphragm is an important respiratory muscle and dysfunction is very common in patients receiving mechanical ventilation. Diaphragm fatigue occurs even in patients who successfully pass the Spontaneous Breathing Test (SBT). Interrupting ventilation too early can lead to increased cardiovascular and respiratory pressure (CO2).retention and hypoxemia with up to 25% of patients requiring reinstitution of ventilator support. Unnecessary delays in liberation from mechanical ventilation also can be deleterious. Complications such as ventilator-associated pneumonia and ventilator-induced diaphragm atrophy can be seen with short periods of mechanical ventilation thereby prolonging mechanical ventilation. As SBT monitoring is insensitive to detect early signs of load-capacity imbalance. The evaluation of the diaphragmatic thickening fraction (DTF) may be also helpful to assess diaphragmatic function and its contribution to respiratory workload. Ultrasound can be used to detect the deflection of the diaphragm, which helps to identify patients with diaphragm dysfunction
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Critically ill patients intubated for more than 48 hours who are ready for weaning with the following criteria.
- •positive end-expiratory pressure (PEEP) ≤ 5 cm H2O.
- •Fraction of inspired oxygen (FiO2) < 0.
- •respiratory rate (RR) < 30 breaths/min.
- •rapid shallow breathing index < 105, PaO2/FiO2 >
- •Age< 65 years.
排除标准
- •Age<18 years.
- •Patient with history of plural effusion, trauma to chest and history of mechanical ventilation for < 6 months.
- •patient with neuromuscular diseases affect diaphragm .
结局指标
主要结局
diaphragmatic ultrasound thickening
时间窗: during weaning from mechanical ventilation 0n T- tube, through study completion, an average of 1 year
Right diaphragmatic ultrasound measurement thickening in millimeter was made during tidal and deep breathing . patient is in the supine position and measurement of right diaphragm by M-mode and B-mode images
diaphragmatic ultrasound thickening fraction
时间窗: during weaning from mechanical ventilation 0n T- tube, through study completion, an average of 1 year
Right diaphragmatic ultrasound measurement thickening fraction(percentage% ) was made during tidal and deep breathing . patient is in the supine position and measurement of right diaphragm by M-mode and B-mode images
diaphragmatic ultrasound excursion
时间窗: during weaning from mechanical ventilation 0n T- tube, through study completion, an average of 1 year
Right diaphragmatic ultrasound measurement excursion( centimeter) was made during tidal and deep breathing . patient is in the supine position and measurement of right diaphragm by M-mode and B-mode images
次要结局
- diaphragmatic ultrasound thickening fraction(Up to 48 hours on T-tube, through study completion, an average of 1 year)
- diaphragmatic ultrasound thickening(Up to 48 hours on T-tube, through study completion, an average of 1 year)
- diaphragmatic ultrasound excursion(Up to 48 hours on T-tube, through study completion, an average of 1 year)
研究者
Ahmed Aelgharib Ahmed
Principal Investigator
Beni-Suef University