None listed
Conditions
Brief summary
Hypothesis: Diagnostic ultrasound may be a useful non-invasive bedside tool to assist with detecting changes in diaphragm and skeletal muscle quantity and quality during mechanical ventilation and may have a relationship with patient functional outcomes on discharge from intensive care Objectives: • To determine the rate and difference in wasting patterns between respiratory and peripheral muscle (as determined by ultrasound imaging). • To determine if baseline ultrasound measurements can predict future patient outcomes such as ICU acquired weakness (ICUAW), Mechamical Ventilation (MV) time etc. Study design: A single-centre prospective observational cohort trial of 62 critically ill patients in a tertiary referral hospital (St Vincent’s Hospital Sydney) in Australia.
Interventions
An ultrasound will be performed by the principle investigator, a physiotherapist, to assess the morphology, cross sectional area and thickness of the knee extensors (both limbs) and excursion thickness of the diaphragm muscle. The first baseline ultrasound examinations will be performed during the first 24-48 hours of mechanical ventilation (initial assessment). The first follow up will be at Day 5 of mechanical ventilation, then serial measures at Day 7, Day 10 and then weekly. A final examinat
An ultrasound will be performed by the principle investigator, a physiotherapist, to assess the morphology, cross sectional area and thickness of the knee extensors (both limbs) and excursion thickness of the diaphragm muscle. The first baseline ultrasound examinations will be performed during the first 24-48 hours of mechanical ventilation (initial assessment). The first follow up will be at Day 5 of mechanical ventilation, then serial measures at Day 7, Day 10 and then weekly. A final examination will be performed up to 72 hours after extubation or liberation from mechanical ventilation for longer than 24 hours. The following additional data will be collected on every participant (at the same intervals of diaphragm and skeletal muscle ultrasound) to calculate measures of lung function and nutritional status: - nutritional parameters: feeding route, volume, product, energy and protein provided - route and mode of mechanical ventilation - Positive end expiratory pressure (PEEP) in cmH2O from the ventilator
Sponsors
St Vincent's Hospital
Study design
Allocation
Non-randomised trial
Primary purpose
Diagnosis
Masking
Blinded (masking used) (Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age >18 years 2. Anticipated treatment duration of mechanical ventilation (MV) for more than 48-hours.
Exclusion criteria
Individuals with spinal cord injury, other primary neuromuscular diseases or new intracranial processes, amputations, previously wheelchair/bed bound, disseminated cancer and lower limb trauma. Body habitus preventing ultrasound imaging with >40 BMI
Outcome results
None listed