Mechanical Ventilation Complication, Respiratory Distress Syndrome, Respiratory Failure
Conditions
Keywords
ultrasound assessment, diaphragm disfuncion
Brief summary
evaluation of diaphragmatic disfunction eventually occurred in pediatric patient undergoing mechanical ventilation therapy
Detailed description
Physician will perform US diaphragm measurements within 36 hours of initiation of MV. Measurements will be repeated daily for the duration of MV for the first week, then every 48 hours and 24 hours after the extubation. Exposure to and duration of continuous NMBA infusion during the course of MV and use of CS will be recorded. Ventilator logs and arterial gas analysis will be checked at the time of each US measurement to ascertain ventilator settings and SBF for the 24 hours preceding each US measurement. Extubation success will be defined as no requirement for reintubation within 48 hours following extubation. The use of NIV immediately after extubation will be decided by the physician in charge according to the patient clinical history (presence of withdrawal syndrome, ect) and NOT according to DTF measurement.
Interventions
OTHERultrasound asessment
US diaphragm measurements within 36 hours of initiation of MV. Measurements will be repeated daily for the duration of MV for the first week, then every 48 hours and 24 hours after the extubation.
Sponsors
Bambino Gesù Hospital and Research Institute
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
28 Days to 18 Years
Healthy volunteers
No
Inclusion criteria
* patients younger than 18 years old * expected clinical requiring of invasive MV for more than 36 hours
Exclusion criteria
* neonates * subjects with preexisting diagnoses of neuromuscular weakness * diaphragm paresis * chronic respiratory failure with ongoing requirement for invasive MV, or continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) or with likely death within 48 hours.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| measurement of occurrence rate of ventilator induced diaphragm disfunction in pediatric patient | through study completion an average of 100 days | the assessment of the actual occurrence rate of VIDD in a population of PICU patients undergoing MV for acute respiratory failure of various etiology |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| evaluation clinical impact of ventilator induced diaphragm disfunction in pediatric patient | through study completion an average of 100 days | evaluation of the impact of VIDD and clinical outcomes of our patients in terms of Mechanical Ventilation free days |
| evaluation of two different diaphragmatic thickening fraction formula (DTF) | through study completion an average of 100 days | evaluate the feasibility and clinical applicability of our formula for the calculation of DTF (mTdi-insp - mTdi-exp)/mTdi-med x 100, comparing it to the standard one (Tdi-insp - Tdi-exp)/Tdi-exp x 100. |
Outcome results
None listed