Examination of respiratory muscle called diaphragm using ultrasound and studying its relation with nutrition of ICU patients

Recruiting

• Conditions: Other specified symptoms and signsinvolving the circulatory and respiratory systems,

• Registration Number: CTRI/2021/01/030617
• Lead Sponsor: Department of Respiratory Therapy Manipal Academy of Higher education Manipal

Brief Summary

On the day of admission to theICU, the mNUTRIC score will be calculated. The patients will be either onoxygen therapy devices like face mask, venturi devices, non-rebreathing bagmask (NRBM), non-invasive ventilation (NIV) or on invasive mechanicalventilation (IMV). Diaphragm muscle thickness and diaphragmatic thicknessfraction (DTF) will be evaluated on the right hemi-diaphragm on day odadmission to ICU ie day 0, day 3, day 7 in ICU. Ultrasound imaging will be donewith B- mode ultrasound with linear transducer probes. With the patients being30-degree head up as usually in the ICU, the linear transducer will be placedperpendicularly on the right chest wall, between the anterior axillary andmid-axillary lines, between 8-10 intercostal space, at the zone of appositionbetween pleura and diaphragm. Measurements of diaphragm muscle thickness willbe done three times at end-expiration, and the mean value will be recorded.Similarly DTF will be evaluated 3 times, and the mean value will be recorded.

Diaphragmatic ThicknessFraction(DTF) = Thickness at end inspiration- Thickness at end expiration/Thickness at end expiration

  On the days 1,3,7 of ICU stay, lung ultrasound will bedone after ultrasonographic evaluation of both lungs, and scoring will be doneas under

**Lung Ultrasound Scoring**

| | | |

| --- | --- | --- |

|**Point for each lung  ultrasound score**

**Degree of lung aeration**

**Pattern**

|0 point

Normal

A lines

|1 point

Moderate loss of aeration

Well separated B lines

|2 point

Severe loss of aeration

Coalescent B lines

|3 point

Complete loss of aeration

Lung Consolidation

Detailed Description

Not available

Study Timeline

• Study Start: 2021-01-26
• Last Update Posted: 2021-09-08

Recruitment & Eligibility

• Status: Open to Recruitment
• Sex: All
• Target Recruitment: 80

Inclusion Criteria

Patients above 18 years admitted to critical care unit and on oxygen support with either invasive ventilation/Non- invasive ventilation ( NIV) / high flow nasal cannula (HFNC) /non rebreathing mask (NRBM) /venturi devices as deemed suitable by ICU consultant.

Exclusion Criteria

• 1.Patients with known neurological disorders.
• 2.Patients with any form of myopathies.
• 3.Patients with chest trauma 4.Patients have any abdominal surgeries in the last 2 months.
• 5.Any patient with known phrenic nerve disorders 6.Post nerve blocks which can alter phrenic nerve function like interscalene or supraclavicular brachial plexus blocks.

Study & Design

• Study Type: Observational
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Rate of change of diaphragm muscle thickness and diaphragmatic thickness fraction (DTF) over time in the patients on various levels of respiratory support, and its association with mNUTRIC score.	on day of admission, day three and day seven

Secondary Outcome Measures

Name	Time	Method
worst P/F ratio, lung ultrasound scores (LUS), days of ventilation on face mask/venturi/NRBM/NIV/IMV, outcome of ICU stay.	on day of admission, day 3 and day 7

Trial Locations

Locations (1)

Department of Critical Care, Kasturba hospital, Manipal; 🇮🇳 Udupi, KARNATAKA, India

Department of Critical Care, Kasturba hospital, Manipal

🇮🇳Udupi, KARNATAKA, India

Pratiba

Principal investigator

8095103671

pratibha.todur@manipal.edu