Expiratory muscle activity and function in critically ill ventilated patients

Recruiting

Conditions: breathing muscle weakness
expiratory muscle dysfunction
10028302
10013369

Registration Number: NL-OMON50539

Lead Sponsor: Vrije Universiteit Medisch Centrum

Brief Summary: Not available

Detailed Description: Not available

Recruitment & Eligibility

Status: Recruiting

Sex: Not specified

Target Recruitment: 20

Inclusion Criteria

- Informed consent
- Age > 18 years
- Invasive mechanical ventilation in assisted modes
- Dedicated feeding catheter (Nutrivent) in situ for measurements of
respiratory mechanics

Exclusion Criteria

- Past history of neuromuscular disorders
- BMI > 30 kg/m2
- Drains/wounds limiting placement of EMG electrodes
- Anticipating withdrawal of life support and/or shift to palliation as the
goal of care

Study & Design

Study Type: Observational non invasive

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
<p>The primary endpoint is the coordination between the diaphragm and expiratory<br /><br>muscles, quantified with 1) the pressure-time product (PTP) ratio of the<br /><br>expiratory muscles versus total breathing PTP (PTPex/(PTPex +PTPin)), and 2) as<br /><br>the activation pattern of the respiratory muscles using EMG.<br /><br>More specific:<br /><br>- Functional coordination will be assessed with the PTP: PTPex = PTP of the<br /><br>expiratory muscles, as derived from Pga recordings during the expiratory phase<br /><br>of breathing (PTPPga,ex).PTPin = PTP of the inspiratory muscles, as derived<br /><br>from Pes recordings and the recoil pressure of the chest wall<br /><br>- Timing coordination is the temporal phase relationship of sequential onset<br /><br>and offset of different muscles (activation pattern), using the EMG-derived<br /><br>phase angle. </p><br>

Secondary Outcome Measures

Name	Time	Method
<p>Outcomes derived from study procedures:<br /><br>- Thoracoabdominal synchrony, as derived from respiratory inductance<br /><br>plethysmography bands.<br /><br>- Electrical activity of the diaphragm as measured with a EAdi catheter (if<br /><br>present) or with surface EMG<br /><br>- Clinical and physiologically relevant parameters, such as ventilator settings</p><br>