Weaning From Mechanical Ventilation
Conditions
Keywords
mechanical ventilation., diaphragmatic thickening Fraction
Brief summary
The aim of this study is to assess the validity of the diaphragmatic thickening Fraction measured by ultrasound as a predictor for successful weaning from mechanical ventilation.
Detailed description
Timing is critical for proper weaning for patients undergoing mechanical ventilation; if this is performed prematurely complications can include increased cardiovascular and respiratory stress, CO2 retention and hypoxemia. However, unnecessary delay in weaning can also cause a number of side-effects.Weaning outcomes have been assessed by several indices. Variables such as minute ventilation, Pao2/Fio2, rapid shallow breathing index and static compliance have all been used, with variable predictive values. Previous studies have proved that diaphragmatic dysfunction is one of the main etiologies of difficult weaning, because the diaphragm progressively weakens with mechanical ventilation.Methods used to assess diaphragm function, such as fluoroscopy, phrenic nerve stimulation, measurement of trans-diaphragmatic pressure and dynamic magnetic resonance imaging of the diaphragm, all have limitations. These include ionizing radiation exposure, low availability, invasiveness and necessity for patient transportation. Conversely, the use of ultrasound is safe, non-invasive, avoids radiation side-effects, and is available at the bedside.The aim of this study is to assess the validity of the diaphragmatic thickening Fraction measured by ultrasound as a predictor for successful weaning from mechanical ventilation.
Interventions
None listed
Sponsors
Mansoura University Hospital
Study design
Observational model
CASE_CROSSOVER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients \>18 years old, who are in need for mechanical ventilation as: Life threatening hypoxia, Respiratory rate \> 30 breath/min, Disturbed conscious level.
Exclusion criteria
* Age \<18 years. * Pregnancy * Surgical incisions likely to interfere with ultrasound examination. * Hepato-splenomegaly, Ascites * Neuromuscular disease as Myasthenia gravis, kypho-scoliosis * Diaphragmatic Paralysis (paralyzed diaphragm exhibiting abnormal paradoxical movement, i.e., moving in a cranial direction during inspiration
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Diaphragmatic thickening Fraction as predictor for weaning from mechanical ventilation. | Baseline and after 6 month | assess the validity of the diaphragmatic thickening Fraction measured by ultrasound as a predictor for successful weaning from mechanical ventilation. |
Countries
Egypt
Contacts
Primary ContactMohamed AbdElmoniem
Backup ContactTaha Taha Abd El Gawad
Outcome results
None listed