Health Condition 1: J00-J99- Diseases of the respiratory system
Conditions
Interventions
Intervention1: Group 2 ( Intervention DE Group): Weaning from mechanical ventilation guided by Diaphragmatic Excursion measurement.
Threshold DE taken as more than 1.5 cm ( ultrasound based measuremen
Sponsors
Institute of Post Graduate Medical Education and Research and SSKM HOSPITALKolkata
Eligibility
Inclusion criteria
Inclusion criteria: Age atleast 18 years Mechanical ventilation for atleast 48 hours with improvement of disease requiring mechanical ventilation Patient can initiate an inspiratory effort Fraction of inspired oxygen FiO2 less than 50 percent Positive end expiratory pressure level less than equal to 8 cm of water Respiratory rate less than 35 breaths per minute Ratio of partial pressure of arterial oxygen (PaO2) to FiO2 more than equal to 150 - 200 mm of Hg SpO2 of atleast 90 percent No use of continued sedation GCS more than 13 and RASS ( Richmond Agitation and Sedation score) between -2 to +1 Hemodynamically stable Hemoglobin level atleast 8 g per dL Effective cough reflex
Exclusion criteria
Exclusion criteria: Age less than 18 or more than 80 years Pregnancy Diaphragmatic palsy or neuromuscular disease Pneumothorax or thoracostomy or rib fractures Cervical spine injury Unstable hemodynamics Low consciousness Refusal of consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Successful extubation (defined as spontaneous breathing more than 48 hours without NIV or reintubation) Extubation failure defined as requirement of reintubation or NIV or Tracheostomy within 48 hours Expected outcome is that there will be atleast 10 percent more successful extubation when Diaphragmatic excursion is used as weaning predictor in comparison to RSBITimepoint: Within 48 hours post extubation | — |
Secondary
| Measure | Time frame |
|---|---|
| Comparison of diaphragmatic thickness fraction (DTF) between success & failure groups Correlation of DTF with RSBI & DE Lung Ultrasound Score (LUS) post-extubation Extubation failure rate ICU stay durationTimepoint: 48 hours post extubation period. | — |
Countries
India
Contacts
Public ContactDr Debojyoti Das
Institute of Post Graduate Medical Education and Research and SSKM Hospital,Kolkata
Outcome results
None listed