Time taken for recovery of inspiratory effort after Neuromuscular blocking agent (NMBA) administration assessed using P 0.1 and risk factors associated with it : An observational study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 100
- 试验地点
- 1
- 主要终点
- Time taken for recovery of inspiratory efforts after neuromuscular blocking agent (NMBA) administration measured by using using P 0.1
研究概览
简要总结
Weaning from mechanical ventilation is a multifactorial process. Presence of optimal inspiratory effort after recovery from Neuromuscular blocking agent (NMBA) is necessary for initiation of weaning . NMBA is used for intubation , preventing patient – ventilator asynchrony, ARDS or management of raised ICP .
NMBA administration leads to loss of spontaneous inspiratory efforts due to blocking of transmission at neuro-muscular junction, causing paralysis of skeletal muscles. Metabolism and excretion of NMBA results in recovery from NMBA effect which leads to initiation of spontaneous inspiratory efforts.
Time taken for recovery of inspiratory effort from NMBA is rarely monitored in citically ill patients .
Recovery of inspiratory efforts from NMBA can be measured by TOF (train of four) , esophageal pressure , electrical activity of the diaphragm , performing diaphragmatic ultrasound and P0.1 . Among all the parameters , P0.1 is non invasive , objective and can be measured easily on ventilator .P 0.1 correlates strongly with inspiratory efforts3.
P 0.1 is the drop in airway pressure (Paw) 100 milliseconds after the onset of inspiration during an end-expiratory occlusion of the airway.
There are no studies regarding the time required to achieve initiation of inspiratory effort after administration of neuro-muscular blocking agent( NMBA) in critically ill patients. The initiation of inspiratory effort translates into optimal inspiratory efforts which in turn leads to initiation of spontaneous breathing mode.
This study will record the time duration between administration of NMBA and onset of recovery of inspiratory efforts on controlled mode .
The time between onset of optimal inspiratory effort on controlled mode to initiation of spontaneous beathing mode. Risk factors associated with recovery of inspiratory efforts will also be recorded .
Insights after analysis can help in formulating pathways for personalised weaning in ICU patients .
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 18.00 Year(s) 至 80.00 Year(s)（—）
- 性别
- All
入选标准
- •1.Patients 18 to 80 years 2.Patients who have received single dose or infusion of NMBA.
排除标准
- •Patients with advanced directive of limitation of care (non escalation) after shared decision making
- •Patients with bainstem dysfunction .
- •Patient with neuromuscular weakness or toxidromes affecting neuromuscular function
- •Patients intubated in emergency.
结局指标
主要结局
Time taken for recovery of inspiratory efforts after neuromuscular blocking agent (NMBA) administration measured by using using P 0.1
时间窗: 4 weeks or till ICU discharge
次要结局
- 1 Time interval between onset of inspiratory effort on controlled mode to initiation of spontaneous mode(2 Duration of ventilation)
研究者
Dr Avinash Kumar
St Johns Medical College and Hospital