Effects of COVID-19 Infection and Critical Illness on Diaphragm Tissue Characteristics and Movement, Visualized With MRI
- Conditions
- Covid19Diaphragm Disease
- Interventions
- Other: Contrast-enhanced MRIOther: Measurement of respiratory muscle force
- Registration Number
- NCT04735757
- Lead Sponsor
- Amsterdam UMC, location VUmc
- Brief Summary
COVID-19-infection has a large impact on the respiratory system and possibly on the diaphragm, the main respiratory muscle. In ICU-patients, diaphragm weakness is associated with prolonged ICU-stay, difficult weaning and increased mortality. Our research group recently found evidence for fibrosis and expression of genes involved in fibrosis as well as viral infiltration of the SARS-CoV-2 virus in diaphragm biopsies from COVID-19 ICU patients. This finding suggests a unique manifestation of diaphragm injury in COVID-19 patients after mechanical ventilation. However, it remains unclear what the exact nature and location of diaphragm injury is.
Additionally, it is largely unknown whether this injury affects the movement of the diaphragm, but this might have important clinical implications. Therefore, we aim at visualizing the tissue characteristics and movement of the diaphragm in COVID-19 patients who recently received long-term mechanical ventilation, other ICU patients and healthy controls, using magnetic resonance imaging (MRI). MRI of the diaphragm was already shown feasible in previous research from our group (article currently under review).
New insights in the characteristics of diaphragm weakness and injury in COVID-19 patients and control ICU-patients will contribute to strategies to prevent it and monitor the diaphragm of patients under mechanical ventilation, which can contribute to better patient outcomes.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 40
Not provided
Not provided
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description ICU patients Contrast-enhanced MRI Patients discharged from the ICU after invasive ventilation for ARDS. COVID-19 patients Contrast-enhanced MRI Patients discharged from the ICU after invasive ventilation for COVID-19. COVID-19 patients Measurement of respiratory muscle force Patients discharged from the ICU after invasive ventilation for COVID-19. ICU patients Measurement of respiratory muscle force Patients discharged from the ICU after invasive ventilation for ARDS. Healthy volunteers Contrast-enhanced MRI Healthy volunteers, matched by age and gender to patient groups. Healthy volunteers Measurement of respiratory muscle force Healthy volunteers, matched by age and gender to patient groups.
- Primary Outcome Measures
Name Time Method Tissue characteristics of the diaphragm 1 hour Extracted from contrast enhanced imaging
Movement of the diaphragm 1 hour Description of the movement of the diaphragm in 4D fashion.
- Secondary Outcome Measures
Name Time Method Quantitative dynamic contrast enhanced imaging of the diaphragm 1 hour Application of modelling to describe tissue characteristics of the diaphragm using contrast inflow.
Correlation of movement and tissue characteristics of the diaphragm with measurements of maximum inspiratory and expiratory pressure 1 hour Correlation of movement and tissue characteristics of the diaphragm with clinical parameters 1 hour Clinical parameters include ventilator settings, biomarkers for inflammation (CRP, white blood cell count) during ICU admission, daily dosage of drugs known with adverse effects on respiratory muscles, fluid balance, protein intake, primary reason for ICU admission and weaning duration.
Trial Locations
- Locations (1)
Amsterdam UMC, location VUmc
🇳🇱Amsterdam, Noord-Holland, Netherlands