Microcirculation in Spontaneous Breathing Trial

Study Overview
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Brief Summary
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Weaning ventilator support in critically ill patients is crucial. Both delayed extubation and unexpected early reintubation are harmful to the patients. Weaning parameters and spontaneous breathing trial are used to investigate the indication and predict the successful extubation. Hemodynamic stability and physical reserve are important indicators as well. Microcirculation parameters are known to be more sensitive to the change of hemodynamic status than macrocirculation parameters. We hypothesize that the change of sublingual microcirculation before and after spontaneous breathing trial is different between the the patients with successful extubation and the patients with failed extubation. Thus, this study measures sublingual microcirculation in patients receiving spontaneous breathing trial and record the extubation status (successful or failed). The microcirculation parameters before and after spontaneous breathing trial are compared between the the patients with successful extubation and the patients with failed extubation.

Official Title
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Association Between Change of Microcirculation After Spontaneous Breathing Trial and Ventilator Weaning

Conditions
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Critically Ill

Intervention / Treatment
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* Other: Microcirculation examination


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: critically ill patients received ventilator longer than 12 hours ready for spontaneous breathing trial GCS coma score equal or higher than 8 Exclusion Criteria: aged less than 20 years patient with tracheostomy patient and patients' relatives are non-native speakers

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Successful extubation<br>The patients pass the spontaneous breathing trial and are successful extubated without reintubation within 72 hours. . | Other: Microcirculation examination<br>* Sublingual microcirculation images were recorded using an incident dark-field video microscope<br>|
| Failed extubation<br>The patients pass the spontaneous breathing trial and are successful extubated with reintubation within 72 hours. . | Other: Microcirculation examination<br>* Sublingual microcirculation images were recorded using an incident dark-field video microscope<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Initial total vessel density | Total vessel density measured by Cytocam before and after spontaneous breathing trial | 0 hour | 
| Change of total vessel density | The difference between the total vessel density measure by Cytocam before and after spontaneous breathing trial | baseline and 1 hour | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Initial perfused vessel density | Perfused vessel density measured by Cytocam before spontaneous breathing trial | 0 hour | 
| Change of perfused vessel density | The difference between the perfused vessel density measure by Cytocam before and after spontaneous breathing trial | baseline and 1 hour | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ventilator, weaning, microcirculation