Weaning Failure
Conditions
Keywords
Quantitative Electroencephalography, ultrasound
Brief summary
Neurocritical patients often face the need for removal of endotracheal tubes. However, despite following the extubation criteria for general critical ill patients, neurocritical patients still exhibit a higher rate of weaning failure, significantly higher than that of general critical ill patients. The extubation criteria for general critical patients emphasize the assessment of lung conditions. However, neurological critical patients often have less severe lung damage, but factors such as consciousness level and coughing ability may significantly influence extubation. Quantitative EEG serves as an objective tool to reflect consciousness level status, while bedside ultrasound can assess respiratory muscle function. Additionally, sputum volume may reflect the condition of lung condition. Therefore, we believe that combination of these three indicators can better predict the success of extubation for neurocritical patients.
Interventions
OTHERQuantitative EEG monitoring and beside ultrasound evaluation
After successful spontaneous breathing trial, neurocritical patients undergo at least 2 hours of quantitative EEG monitoring before extubation. Additionally, bedside ultrasound assesses the thickness and variability of the diaphragm, intercostal muscles, rectus abdominis, transversus abdominis, and external oblique muscles. The sputum volume for the 24 hours prior to extubation is also recorded. Reintubation within 48 hours after extubation is defined as weaning failure.
Sponsors
Qingdao University
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Neurocritical patients with endotracheal intubation; * Successful spontaneous Breathing Trial; * The patients meet extubation criteria evaluated by clinical physician
Exclusion criteria
* Patients whose families have opted for cessation of treatment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Quantitative EEG indicators | 2 hours before extubation | These indicators including amplitude EEG and the proportion of α，β，δ，θ wave |
| Respiratory muscles thickness in centimeter | 2 hours before extubation | Muscle thickness was evaluated by ultrasound. |
| Respiratory muscles thickening fraction (%) | 2 hours before extubation | Muscle thickening fraction was evaluated by ultrasound. It equals (end-inspiratory thickness - end-expiratory thickness)/end-expiratory thickness × 100%. |
| Sputum volume in milliliter | 24 hours before extubation | The amount of sputum |
Contacts
Primary Contactbo yao, Dr.
Outcome results
None listed