Health Condition 1: - Health Condition 2: O- Medical and Surgical
Conditions
Interventions
Intervention1: Positive pressure extubation: After a successful spontaneous breathing trial, thorough oral suctioning of the patients in the ICU will be done. The patients in this group will then be c
Sponsors
ALL INDIA INSTITUTE OF MEDICAL SCIENCES NEW DELHI
Eligibility
Inclusion criteria
Inclusion criteria: Patients mechanically ventilated with an endotracheal tube for at least 72 hours Patients deemed fit for extubation by the following criteria or by the physicians discretion PaO2 greater than or equal to 60 mm Hg on FIO2 lesser than or equal to 50 percentage SaO2 greater than or equal to 90% on FIO2 lesser than or equal to 50 percentage pH greater than or equal to 7.32 or a decrease in pH less than 0.07 from baseline of SBT Rapid shallow breathing index less than 105 breaths per min per Litre Respiratory rate less than or equal to 35 breaths per min or increase less than 50 percentage from baseline of SBT Hemodynamically stable patient Successful T-piece or Pressure support ventilation trial for 30 minutes
Exclusion criteria
Exclusion criteria: Patients planned in advance to be extubated directly to NIV or High flow nasal cannula Patients with severe asthma bullous lung disease or severe emphysematous lung disease Patients with suspected raised ICP Patients with a poor GCS of less than 8
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Comparison of lung aeration of patients who undergo traditional extubation with those undergoing positive pressure extubation using lung ultrasound.Timepoint: End of SBT 30 Mins Post Extubation 6 Hours Post Extubation 24 Hours Post Extubation | — |
Secondary
| Measure | Time frame |
|---|---|
| Change in lung ultrasound scores pre and post extubation in the two groupsTimepoint: End of SBT 30 Mins Post Extubation 6 Hours Post Extubation 24 Hours Post Extubation;Change in the A-aO2 gradient pre and post extubation in the two groupsTimepoint: End Of SBT 1 Hour Post Extubation;Chest X-ray findings between the two groupsTimepoint: Before Extubation 24 Hours Post Extubation;ICU free days and Reintubation rates between the two groupsTimepoint: ICU free days at 28 days Reintubation rates at 72 hours and 28 days;Incidence of adverse clinical events between the two groupsTimepoint: Extubation failure within 48 hours Desaturation within 48 hours New onset bronchospasm within 48 hours Tachypnea within 30 minutes Tachycardia within 30 minutes Hypertension within 30 minutes Pneumonia within 48 hours | — |
Countries
India
Contacts
Public ContactDR DARLONG V
ALL INDIA INSTITUTE OF MEDICAL SCIENCES NEW DELHI
Outcome results
None listed