Diaphragm Ultrasound Measurements With Variations in Modes of Ventilation
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 66
- 试验地点
- 1
- 主要终点
- End expiratory diaphragm thickness in controlled and spontaneous modes
研究概览
简要总结
The overall objective of the study is to conduct an observational study involving intensive care unit patients receiving mechanical ventilation and determine if there are differences in diaphragm thickness ultrasound measurements during expiratory and inspiratory phases in a controlled and spontaneous mode. For patients receiving sedatives, an additional set of measurements will be taken during a standard of care interruption of sedatives
详细描述
In this study diaphragm ultrasound measurements at end-expiration and peak inspiration phases in assist control and pressure support mode in consented patients admitted to the medical intensive care unit. One-time measurements will be obtained during the first 48hrs that the patients are receiving mechanical ventilation. In patients receiving sedatives, additional measurements will be taken after an interruption of sedatives. Measurements will be compared between modes and on assist-control before and after an interruption of sedatives.
Three consecutive images will be obtained by an investigator that is blinded to the mode (controlled vs. spontaneous). Once measurements are obtained, a second investigator will switch to the other mode (controlled vs. spontaneous) and the blinded investigator will obtain three consecutive images after the patient has adjusted to the subsequent mode (one minute). Tidal volumes will be matched between modes as close as possible. The order of modes to ultrasound (controlled then spontaneous or spontaneous then controlled) will be determined by the non-blinded second investigator. Once the ultrasound measurements are obtained by the research team, image acquisition is concluded for the enrolled patient. The ventilator will be programmed back to the original settings determined by the medical ICU team.
The hypothesis is that the end-expiration diaphragm ultrasound measurement will be thicker in spontaneous mode than controlled mode.
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 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients > 18 years of age
- •intubated and mechanically ventilated for < 48 hours at the time of screening
排除标准
- •pregnancy
- •history of diaphragmatic paralysis
- •neuromuscular blockade
- •cardiac arrest
结局指标
主要结局
End expiratory diaphragm thickness in controlled and spontaneous modes
时间窗: Less than 48 hours after mechanical ventilation
Diaphragm ultrasound measurement at end expiration in assist control mode and pressure support mode
次要结局
- Variance in peak inspiration thickness in controlled and spontaneous modes(Less than 48 hours after mechanical ventilation)
- p0.1 measurements in controlled and spontaneous modes(Less than 48 hours after mechanical ventilation)
- Thickening fraction in controlled and spontaneous modes(Less than 48 hours after mechanical ventilation)