Premature
Conditions
Keywords
tissue Doppler imaging, Premature infants, extubation, diaphragm
Brief summary
Weaning from mechanical ventilation is a critical issue and the diaphragmatic disfunction has been demonstrated to play an important role in extubation failure. the aim of present investigation is to evaluate diaphragmatic excursion velocity during in patients undergoing spontaneous breathing trial through tissue Doppler analysis in both inspiration and expiration.
Interventions
DEVICEdiaphragmatic tissue Doppler imaging，dTDI
dTDI was performed at the end of the SBT to assess excursion, velocity, and acceleration.
Sponsors
Wang Jianhui
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
2 Days to 6 Months
Healthy volunteers
No
Inclusion criteria
* premature infants with gestational age \<32 weeks and supported by invasive mechanical ventilation ≥48 hours * All the indications for extubation are met：cough or vomiting due to spontaneous breathing and sputum aspiration; ventilator parameters in recent 24 hours: MAP \< 8cmH2O, RR \< 30 times/min, FiO2 \< 30%; Arterial blood gas: pH \> 7.25, (PaCO2\< 60mmHg, BE \< 8mmol/L, oxygen saturation \> 90% * a successful SBT * parents or legal guardians sign informed consent to attend this study
Exclusion criteria
* accidental extubation * chest CT or bronchoscopy during hospitalization indicated congenital airway dysplasia * complex congenital heart disease * congenital metabolic diseases, neuromuscular diseases * severe brain injury * surgical mechanical ventilation * give up before extubation; * pneumothorax or pleural effusion * no consent is signed
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in diaphragmatic displacement velocity | an average of 20 minutes | Inspiratory and expiratory diaphragmatic displacement velocity evaluated with tissue doppler during the assisted ventilation modality which preceded the trial, during the spontaneous breathing trial and in spontaneous breathing. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Gas exchange - arterial carbon dioxide tension | through each trial completion, an average of 20 minutes | Arterial blood gases sample |
| Gas exchange - pH | an average of 20 minutes | Arterial blood gases sample |
| Diaphragmatic acceleration and deceleration | an average of 20 minutes | Diaphragmatic acceleration and deceleration evaluated with tissue doppler during the assisted ventilation modality which preceded the trial, during the spontaneous breathing trial and in spontaneous breathing. |
| Silverman Andersen Respiratory Severity Score (SA-RSS) | an average of 20 min | SA-RSS to assess work of breathing after extubation. |
| Number of patients who experienced weaning failure | 48 hours | the need for non invasive ventilation or re-intubation due to any cause |
| Gas exchange - arterial oxygen tension | an average of 20 min | Arterial blood gases sample |
Countries
China
Contacts
Primary ContactJianhui Wang, Doctor
Outcome results
None listed