Ventilation Therapy; Complications
Conditions
Keywords
abdominal muscles, ultrasound
Brief summary
Weakness of respiratory muscles is frequent after several days of mechanical ventilation. Thereby an acquired diaphragm weakness has been demonstrated, linked to an atrophy which may be identified by a decrease of muscle thickness in echography. This study aims to evaluate with ultrasound the variation of thickness of abdominal muscles after 7 days of mechanical ventilation.
Detailed description
Weakness of respiratory muscles is frequent after several days of mechanical ventilation. Thereby an acquired diaphragm weakness has been demonstrated, linked to an atrophy which may be identified by a decrease of muscle thickness in echography. Weakness of expiratory muscles is also frequent after 7 days of mechanical ventilation, however his cause is not clear: is it present at admission notably in elderly patients, or acquired on mechanical ventilation ? Ultrasound allows to measure the thickness of abdominal muscles which correlates with their strength. This study aims to evaluate with ultrasound the variation of thickness of abdominal muscles after 7 days of mechanical ventilation.
Interventions
DEVICEUltrasound
Ultrasound evaluation of the variation of thickness of abdominal muscles after 7 days of mechanical ventilation.
Sponsors
Centre Hospitalier Universitaire de Saint Etienne
Centre Hospitalier de Roanne
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient affiliated or entitled to a social security plan * Expected duration of mechanical ventilation \> 7 days * Trusted person/relative who has signed a consent to participate in the study
Exclusion criteria
* Patient with a pre-existing neuromuscular pathology * No access to ultrasound Windows (dressing, drainages...) * Patient transferred from another intensive care unit * Patient Under guardianship or curators
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Thickness of the abdominal muscles (mm) | Day 7 | It is the sum of the thickness of rectus abdominal muscle + external oblique + internal oblique + transverse muscles. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Thickness of the external oblique abdominal muscles (mm) | Day 7 | Thickness of the external oblique abdominal muscles (mm) by ultrasound measurement |
| Thickness of the internal oblique abdominal muscles (mm) | Day 7 | Thickness of the internal oblique abdominal muscles (mm) by ultrasound measurement |
| Thickness of the transverse abdominal muscles (mm) | Day 7 | Thickness of the transverse abdominal muscles (mm) by ultrasound measurement |
| Diaphragmatic thickness (mm) | Day 7 | Diaphragmatic thickness (mm) measured by ultrasound |
| Number of day with a contraction of the transverse abdominal muscle | From day 1 to day 7 | Ultrasound search for a contraction of the transverse abdominal muscle during the morning clinical examination each day from D1 to D7 |
| Caught peak expiratory flow (CPEF) (cmH2O) | Day 7 | Only for conscious patients, responding to the simple command and tolerating minimal respiratory support (inspiratory support 7 cmH20, Pep 0 cmH20) caught peak expiratory flow (CPEF) measurement |
| Maximum expiratory pressure (l/min) | Day 7 | Only for conscious patients, responding to the simple command and tolerating minimal respiratory support maximum expiratory pressure (PE max) measurement |
| Thickness of the rectus abdominal muscles (mm) | Day 7 | Thickness of the rectus abdominal muscles (mm) by ultrasound measurement. |
| Thickness of the internal oblique abdominal muscle (mm) | Immediately after the successful extubation of the patient | Internal oblique abdominal muscle by ultrasound measurement |
| Thickness of the transverse abdominal muscle (mm) | Immediately after the successful extubation of the patient | Transverse abdominal muscle by ultrasound measurement |
| Thickness of the rectus abdominal muscle (mm) | Immediately after the successful extubation of the patient | Rectus abdominal muscle by ultrasound measurement |
| Number of day between day 7 and successful extubation day (days) | From Day 7 to the day when the patient will be extubated successfully | — |
| Duration of sedation (Day) | At intensive care unit discharge | — |
| Duration of curarization (Day) | At intensive care unit discharge | — |
| Thickness of the external oblique abdominal muscle (mm) | Immediately after the successful extubation of the patient | External oblique abdominal muscle by ultrasound measurement |
Countries
France
Outcome results
None listed