Ultrasound Assessment During Weaning from Mechanical Ventilation

Launched by HOSPITAL ITALIANO DE BUENOS AIRES · Sep 19, 2024

Keywords

ClinConnect Summary

The ECO-WEANING study is looking at whether ultrasound tests of the lungs, heart, and diaphragm can help predict which patients may need to be put back on a breathing tube after doctors remove it. By taking ultrasound readings during a trial where patients try to breathe on their own, researchers hope to build a model that can identify those at higher risk of extubation failure (re-intubation or death) within about 48 hours.

Eligibility is for adults 18 and older who have been on a ventilator for more than 48 hours and are ready for a spontaneous breathing trial. Ultrasound measurements are done 20–30 minutes after the trial begins. Some people cannot participate, such as those with certain severe heart conditions, neuromuscular disease, or poor ultrasound windows, or where stopping ventilation isn’t appropriate. If enrolled, participants will have their ultrasound data collected and medical records reviewed, with follow-up for up to 7 days after extubation to see if the tube is needed again. This is an observational study (no new drug or device being tested) enrolling about 429 participants across multiple ICUs internationally.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Adult patients (18 years or older).
• • Receiving mechanical ventilatory assistance for more than 48 hours.
• • The patient is deemed ready to undergo a Spontaneous Breathing Trial, as determined by the attending physician.
• • Ultrasound measurements are performed between 20 and 30 minutes after the initiation of the trial.
• Exclusion Criteria:
• • Patients with known or diagnosed neuromuscular disease.
• • Limitation of therapeutic effort
• • History of severe valvulopathy, severe coronary artery disease, known left ventricular ejection fraction \<35%, or known grade 3 diastolic dysfunction, or who are considered candidates for tracheostomy due to their severity.
• • History of home ventilatory support
• • Patients who do not have a good acoustic window or have any type of limitation to perform pulmonary, cardiac, or diaphragmatic ultrasound.
• • Patients who at the discretion of the treating medical team cannot be placed on a T-tube.