Acute Respiratory Failure, Dyspnea
Conditions
Keywords
Diaphragmatic Excursion, Diaphragmatic Dysfunction, Emergency Department, Respiratory insufficiency, Acute respiratory failure
Brief summary
Acute respiratory failure is one of the most common diagnosis in patients admitted in the Emergency Department. Acute respiratory failure is associated with morbidity and mortality. Fifteen percent of patient will require ventilatory support and among them 40% will die. Measurement of diaphragmatic motion (excursion) at ultrasonography is a noninvasive measure, allowing to assess diaphragm dysfunction. It could be useful in predicting poor prognosis in ED patients with respiratory failure . In this study the investigators will compare the prognostic value of diaphragmatic excursion measurement at ultrasonography to that of the National Early Warning Score (NEWS) 2 in patients presenting with acute respiratory failure in the ED The Investigators made the hypothesis that measurement of diaphragmatic excursion in ED patients with acute respiratory failure could be of value in predicting the need for ventilatory support or mortality within 28 days from ED admission
Detailed description
Diaphragmatic dysfunction can be explored by measuring diaphragmatic excursion using ultrasonography in spontaneous ventilation patients. Patients in spontaneous ventilation will undergo both diaphragmatic excursion measurement at ultrasonography and assessment of the News2 score as part of standard care.
Interventions
None listed
Sponsors
Poitiers University Hospital
University Hospital, Brest
Nord-Vienne Hospital
University Hospital, Montpellier
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age equal or over 18 y.o * Signs of acute respiratory failure defined by RR equal or over 25 br/min and/or signs of increased work of breathing * Patients on spontaneous breathing
Exclusion criteria
* Medical history of diaphragmatic dysfunction including stroke or diaphragmatic paralysis * Patients on ventilatory support at ED admission or prior to inclusion * Patients treated with curare * Trauma patients
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients with adverse events | 28 days | Adverse events are defined as a composite of mortality and/or cardiac arrest and/or need for ventilatory support (including invasive and/or noninvasive ventilation and/or high flow nasal cannula therapy) within 28 days from ED admission. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Delay to initiation of ventilatory support | at day 28 | Ventilatory support is defined as invasive mechanical ventilation or non invasive ventilation or high-flow nasal cannula |
| Number of patients with adverse events at ED discharge | through ED stay (up to a day) | Adverse events are defined as a composite of mortality and/or cardiac arrest and/or need for ventilatory support (including invasive and/or noninvasive ventilation and/or high flow nasal cannula therapy). |
| Number of patients with adverse events at hospital discharge | through hospital stay (up to a week) | Adverse events are defined as a composite of mortality and/or cardiac arrest and/or need for ventilatory support (including invasive and/or noninvasive ventilation and/or high flow nasal cannula therapy). |
Countries
France
Outcome results
None listed