Ultrasound Assessment of the Thickening Fraction of the Respiratory Muscles for Predicting Weaning Outcomes

Launched by TANTA UNIVERSITY · Dec 6, 2024

Keywords

ClinConnect Summary

This clinical trial is studying how ultrasound can help doctors measure the thickening of certain respiratory muscles, like the diaphragm, to see if patients can safely stop using a ventilator. The goal is to better predict which patients are ready to breathe on their own after being on mechanical ventilation for at least 48 hours. This research is important because it may help improve the process of weaning patients off ventilators, making it safer and more effective.

To be part of this study, participants need to be at least 18 years old and have been on a ventilator for more than two days. They should be awake and able to cooperate, with stable health conditions and adequate breathing function. However, patients who are pregnant, have certain medical conditions like rib fractures or neuromuscular disorders, or who have previously struggled to breathe on their own after mechanical ventilation won't be eligible. If chosen to participate, patients will undergo non-invasive ultrasound assessments to evaluate their muscle function, which will help guide their care during the weaning process.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• * Patients will be enrolled if they are ≥18 years old, on invasive mechanical ventilation (MV) for more than 48 h and are eligible for first spontaneous breathing trial (SBT) after fulfilling all the following criteria:
• • 1. Resolution or improvement of the disease leading to MV.
• • 2. Adequate oxygenation, indicated by arterial oxygen partial pressure to inspired oxygen fraction (PaO2/FiO2) ≥ 200 mmHg, both with positive end-expiratory pressure (PEEP) ≤ 5 cmH2O and rapid shallow breathing index\< 105.
• • 3. Adequate pulmonary function, indicated by a RR\<30 breaths/min with VT ≥5 mL/kg ideal body weight (IBW) and no significant respiratory acidosis with normal serum electrolytes.
• • 4. Stable hemodynamics status, without or with minimal vasopressors
• • 5. Conscious and cooperative patient
• • 6. Absence of excessive tracheobronchial secretion (\<3 times suction in the past 8 hours).
• 7. Effective cough reflex .Exclusion Criteria:
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• • 1. Pregnancy.
• • 2. Presence of tracheostomy, pleural effusion, pneumothorax, pneumomediastinum, or hemothorax.
• • 3. Presence of rib fractures.
• • 4. Pre-existing cervical spinal injury, history or final diagnosis of neuromuscular disorders, and diaphragmatic paralysis or disorders
• • 5. Use of neuromuscular blocking agents within 48 hours.
• • 6. A distorted abdominal wall anatomy, or damage to the abdominal wall.
• • 7. Patients with localized fluid collections in the abdomen, hernias, abdominal wall hematomas, inguinal masses, femoral hernias, abdominal surgeries.
• • 8. BMI≥ 40
• • 9. Patients with previously failed SBT