Health Condition 1: - Health Condition 2: M049- Autoinflammatory syndrome, unspecified Health Condition 3: J22- Unspecified acute lower respiratory infection
Conditions
Interventions
Intervention1: nil: nil
Sponsors
Raju shakya
Eligibility
Inclusion criteria
Inclusion criteria: (a) age > 18 years; (b) mechanically ventilated for more than 48 hrs; (c) clinical improvement of the underlying acute cause of respiratory failure; (d) adequate cough reflex; (e) absence of excessive and/or purulent tracheobronchial secretion; (f) stable cardiovascular status (i.e. heart rate no/minimal vasopressor use, i.e., dopamine or dobutamine noradrenaline (g) stable metabolic status (i.e. electrolytes and glucose within normal range, body temperature =8â??10 g/dL; (h) adequate oxygenation (SaO2) >92 % with FiO2 PaO2/FiO2 >=150 mmHg, both with PEEP (i) adequate pulmonary function (i.e., RR =5 mL/kg ideal body weight (IBW) and no significant respiratory acidosis; and (j) Richmond Agitation and Sedation Scale score ranging between â??1 and +1
Exclusion criteria
Exclusion criteria: (a) age (b) pregnancy; (c) presence of thoracostomy, pneumothorax, or pneumomediastinum; (d) presence of flail chest or rib fractures; (e) neuromuscular disease; (f) use of neuromuscular blockers in the previous 48 h of study; and (g) history or new detection of paralysis or paradoxical movement of a single hemidiaphragm on diaphragmatic ultrasonography.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Successful weaning is defined as sustained spontaneous breathing for at least 48 h after extubation. Failed weaning is defined as need for reintubation / NIV within 48 h of extubation.Timepoint: The patients who meet eligibility criteria will be assessed after 30 minutes of SBT for readiness to extubate, then ventilator indices (HR, MAP, RSBI, MV & Pao2/ Fio2) will be recorded at the end of successful SBT. | — |
Secondary
| Measure | Time frame |
|---|---|
| Successful weaning is defined as sustained spontaneous breathing for at least 48 h after extubation. Failed weaning is defined as need for reintubation / NIV within 48 h of extubation.Timepoint: The patients who meet eligibility criteria will be assessed after 30 minutes of SBT for readiness to extubate, then ultrasound indices like diaphragmatic thickness, diaphragmatic excursion and speed of diaphragmatic contraction will be recorded at the end of successful SBT. | — |
Countries
India
Contacts
Public ContactRaju shakya
Indraprastha Apollo Hospital
Outcome results
None listed