Health Condition 1: J962- Acute and chronic respiratory failure
Conditions
Interventions
Intervention1: Nil: Nil
Sponsors
DR HARSH RATHORE
Eligibility
Inclusion criteria
Inclusion criteria: 1. Age more than 18 years 2. Patients requiring invasive mechanical ventilation within 24 hours of ICU admission 3. Expected duration of mechanical ventilation more than 48 hours (as assessed by the treating intensivist) 4. Ability to obtain informed consent from the patient or legally acceptable representative
Exclusion criteria
Exclusion criteria: 1. Patients with pre-existing neuromuscular disorders. 2. Patients with known diaphragmatic pathology (diaphragmatic paralysis, eventration, or prior phrenic nerve injury) 3. Patients with spinal cord injury at the cervical or high thoracic level 4. Patients with previous lower limb amputation or pathology preventing RFCSA measurement 5. Morbid obesity (BMI more than 40), limiting adequate ultrasound visualization 6. Presence of chest tubes, surgical dressings, or wounds preventing ultrasound probe placement 7. Patients with do-not-resuscitate (DNR) or comfort care status at ICU admission 8. Pregnancy 9. Patients who are readmitted to the ICU after previous enrolment in the study 10. Refusal of consent by patient or legally acceptable representative 11. Patients who are expected to be transferred to another facility within 5 days.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Association between serial muscle ultrasound measurements [diaphragm excursion (DE), diaphragm thickening fraction (DTF), and rectus femoris cross-sectional area (RFCSA)] and weaning outcomes in mechanically ventilated critically ill patients stratified by mNUTRIC score (high vs low).Timepoint: day 1 and 5 | — |
Secondary
| Measure | Time frame |
|---|---|
| To compare the changes in muscle ultrasound parameters (DE, DTF, and RFCSA) on ICU admission (Day 1) and Day 5 between patients with high mNUTRIC score versus low mNUTRIC score. Timepoint: 28 days;To evaluate the association between daily caloric and protein intake during the first 5 ICU days and the magnitude of change in diaphragmatic function (DE and DTF) and peripheral muscle mass (RFCSA). Timepoint: 28 days;To determine whether baseline or serial measurements of muscle ultrasound parameters independently predict weaning success after adjusting for illness severity scores (APACHE II/SOFA), mNUTRIC score, and baseline characteristics.Timepoint: 28 days;To assess the association between muscle ultrasound findings and clinical outcomes, including 28-day mortality, ICU length of stay, and organ support requirements (vasopressors and renal replacement therapy).Timepoint: 28 days | — |
Countries
India
Contacts
Public ContactHARSH RATHORE
Amrita institute of medical sciences, Faridabad
Outcome results
None listed