Diaphragm Excursion, Mechanically Ventilated ICU Patients
Conditions
Brief summary
The goal of this clincal trial is to learn if doxapram is effective in weaning in adults on mechanical ventilation. The objectives of this study: * Evaluate the effect of doxapram on diaphragmatic function (assessed by DE)during weaning from mechanical ventilation. * Assess the impact of doxapram on respiratory muscle sterngth. * Mointor adverse effects associated with doxapram administration. Researchers will compare expermental group(intervenous doxapram during weaning)with control group(saline infusion)during weaning. The patients who fulfull criteria of weaning will be subjected to our clincal trial and put on spontanous breathing trial for 120mins using positive end expiratory pressure (peep)5 cmh2o,pressure support 5cm h2o and fio2 0.3.By the end of the SBTthe patient will be extubated if ventilator parameters and vital signs were maintained within 20%of baseline values. The patients will be followed up after extubation and afailed weaning will be defined as the neeed for either invasive or non invasive ventilation for 72 after extubation or failed SBT.
Interventions
DRUGDoxapram
Doxapram is used as a respiatory stimulant intended to enhance respiratory drive and diaphragmatic activity durig ventilator weaning.
Sponsors
Kasr El Aini Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Intervention model description
prospective,randomized,double blinded,placebo-controlled trial.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults (≥18 years) on mechanical ventilation for \>48 hours. * Deemed ready for weaning by the clinical team: Defined as RSBI \<105, P/F ratio \>200, hemodynamic stability. * Stable hemodynamics and adequate oxygenation (PaO₂/FiO₂ \>150)
Exclusion criteria
* Severe neurological impairment :Defined as GCS ≤8 or spinal cord injury above T5 . * Known hypersensitivity to doxapram. * Pregnancy or lactation.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| - Diaphragmatic excursion (DE) measured by ultrasound. | Baseline(immediately before initiation of weaning trial) ,and at 15 minutes,60 minutes,and 120 minutes after initiation of weaning trial. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Maximal Inspiratory Pressure(MIP) | Baseline and during weaning trial up to 120 minutes. | — |
| Weaning Success Rate | Within 48hr after extubation. | Successful liberation from mechanical ventilation without the need for reintubation or noninvasive ventilatory support. |
Contacts
CONTACTahmed mekhemar Mekhemar, doctor
Outcome results
None listed