Airway Extubation
Conditions
Keywords
Airway Extubation, Ultrasonography, Ventilator Weaning
Brief summary
The primary objective is to assess whether the fraction of diaphragmatic shortening in combination with the presence / absence of alveolar-interstitial syndrome evaluated through chest ultrasound may predict successful extubation in adult patients hospitalized in the intensive care unit.
Detailed description
The primary objective is to assess whether the fraction of diaphragmatic shortening in combination with the presence / absence of alveolar-interstitial syndrome evaluated through chest ultrasound may predict successful extubation in adult patients hospitalized in the intensive care unit. The investigators' null hypothesis is the fraction of diaphragmatic shortening in combination with the presence / absence of alveolar-interstitial syndrome evaluated through chest ultrasound can not predict the success of extubation in adult patients hospitalized in the intensive care unit. The alternative hypothesis is the fraction of diaphragmatic shortening in combination with the presence / absence of alveolar-interstitial syndrome evaluated through chest ultrasound may predict successful extubation in adult patients hospitalized in the intensive care unit. The study is a no experimental study of diagnostic test, prospective with longitudinal capture. The study will consist of two parts: the first with the aim of finding the values best combination of sensitivity and specificity compared to extubation success for diaphragmatic shortening fraction and the number of lung quadrants with lines B. In the second part the study will make the prospective validation of these values.
Interventions
DEVICEThoracic ultrasound
The ultrasound will be performed using the ultrasound system GE Logiq XP equipped with a linear probe of 10 MHz. The diaphragm is visualized as two parallel echogenic lines at the eighth intercostal space in the mid-axillary line. The images will be captured during the inspiratory and expiratory tidal volume to and during maximum inspiration and expiration. Each image will be frozen in B mode and the diaphragm thickness will be measured from the center line pleural half the peritoneal line. The fraction of diaphragmatic thickening it is calculated by the formula: diaphragmatic thickness at the end of inspiration - thickness to diaphragmatic at the end of exhalation / diaphragmatic thickness at the end of exhalation x 100. The number of areas with lines B also will be measured.
Sponsors
Hospital Universitario Dr. Jose E. Gonzalez
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 18 years of older * Hospitalized in medical or surgical intensive care unit * Successful spontaneous ventilation trial
Exclusion criteria
* Patients reintubated after a first failure after extubation * Injuries to prevent conduct ultrasound * Pregnancy * History of neuromuscular disease * Brain injury that prevented adequate protection of the airway (Glasgow Coma Scale \<8) * Unilateral or bilateral Pneumothorax * Presence of chest tube in right hemothorax * Right subphrenic abscess * Known uni- or bilateral phrenic nerve injury * Unilateral or bilateral diaphragmatic Paralysis * Unwillingness of the patient or guardian to participate in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Extubation success | 72 h after extubation | The investigators consider successful extubation when the patient does not require reintubation within 72 hours of its extubation |
Countries
Mexico
Outcome results
None listed