Ultrafast Ultrasonographic Oro-laryngeal Measurement in Critically Ill Patients During Weaning From Mechanical Ventilation

Study Overview
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Brief Summary
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In ICU, ventilatory weaning failure is common, accounting for up to 25% of extubations. These failures are largely due to swallowing disorders and laryngeal edema. Edema prevalence in ICU varies between 4 and 37%. Post-extubation stridor is a clinical sign of upper airway obstruction and may require urgent reintubation, which is associated with increased patient length of stay, morbidity and mortality. Identifying patients at risk is critical, and the need for reliable tools to predict the occurence of laryngeal edema is still relevant.

Official Title
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Ultrafast Ultrasonographic Oro-laryngeal Measurement in Critically Ill Patients During Weaning From Mechanical Ventilation

Conditions
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Laryngeal Edema

Intervention / Treatment
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* Other: Ultrafast ultrasonography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults, Intubated and ventilated for more than 24h, Filing mechanical ventilation weaning criteria. Exclusion Criteria: Pregnant of breast-feeding woman, Under guardianship patient, History of laryngeal tumor, stroke, paralysis of recurrent nerve, swallowing disorders, History of surgical laryngeal intervention or radiotherapy, Unplanned extubation, Opposition to take part in the study.

Ages Eligible for Study
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Minimum Age: 18 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

| Intervention/Treatment |
| --- |
|Other: Ultrafast ultrasonography|Ultrasonography of the neck, patient in supine position, neck hyper-extended. Three different scanning planes containing several landmarks. Carried out in the 12h prior extubation.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation between laryngeal ultrafast ultrasonography and occurence of laryngeal edema | A laryngeal edema is defined as a post-extubation stridor. Performance of ultrafast ultrasonography for laryngeal edema prediction in intensive care patients will be assessed with specificity, sensitivity, positive predictive value and negative predictive value. | Within the 24 hours following extubation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation between laryngeal ultrafast ultrasonography and occurence of swallowing disorders | Performance of ultrafast ultrasonography for swallowing disorsders prediction in intensive care patients will be assessed with specificity, sensitivity, positive predictive value and negative predictive value. | Within the 24 hours following extubation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Post-extubation stridor, Intensive care unit, Ultrafast ultrasonography