Diaphragmatic and Pulmonary US for Extubation Success Prediction

Study Overview
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Brief Summary
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The primary objective is to assess whether the fraction of diaphragmatic shortening in combination with the presence / absence of alveolar-interstitial syndrome evaluated through chest ultrasound may predict successful extubation in adult patients hospitalized in the intensive care unit.

Detailed Description
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The primary objective is to assess whether the fraction of diaphragmatic shortening in combination with the presence / absence of alveolar-interstitial syndrome evaluated through chest ultrasound may predict successful extubation in adult patients hospitalized in the intensive care unit. The investigators' null hypothesis is the fraction of diaphragmatic shortening in combination with the presence / absence of alveolar-interstitial syndrome evaluated through chest ultrasound can not predict the success of extubation in adult patients hospitalized in the intensive care unit. The alternative hypothesis is the fraction of diaphragmatic shortening in combination with the presence / absence of alveolar-interstitial syndrome evaluated through chest ultrasound may predict successful extubation in adult patients hospitalized in the intensive care unit. The study is a no experimental study of diagnostic test, prospective with longitudinal capture. The study will consist of two parts: the first with the aim of finding the values best combination of sensitivity and specificity compared to extubation success for diaphragmatic shortening fraction and the number of lung quadrants with lines B. In the second part the study will make the prospective validation of these values.

Official Title
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Diaphragmatic Shortening Fraction and Pulmonary Ultrasound Combined Analysis for Extubation Success Prediction in Critical Care Patients

Conditions
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Airway Extubation

Intervention / Treatment
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* Device: Thoracic ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years of older Hospitalized in medical or surgical intensive care unit Successful spontaneous ventilation trial Exclusion Criteria: Patients reintubated after a first failure after extubation Injuries to prevent conduct ultrasound Pregnancy History of neuromuscular disease Brain injury that prevented adequate protection of the airway (Glasgow Coma Scale <8) Unilateral or bilateral Pneumothorax Presence of chest tube in right hemothorax Right subphrenic abscess Known uni- or bilateral phrenic nerve injury Unilateral or bilateral diaphragmatic Paralysis Unwillingness of the patient or guardian to participate 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 |
| --- |
|Device: Thoracic ultrasound|The ultrasound will be performed using the ultrasound system GE Logiq XP equipped with a linear probe of 10 MHz. The diaphragm is visualized as two parallel echogenic lines at the eighth intercostal space in the mid-axillary line. The images will be captured during the inspiratory and expiratory tidal volume to and during maximum inspiration and expiration. Each image will be frozen in B mode and the diaphragm thickness will be measured from the center line pleural half the peritoneal line. The fraction of diaphragmatic thickening it is calculated by the formula: diaphragmatic thickness at the end of inspiration - thickness to diaphragmatic at the end of exhalation / diaphragmatic thickness at the end of exhalation x 100. The number of areas with lines B also will be measured.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Extubation success | The investigators consider successful extubation when the patient does not require reintubation within 72 hours of its extubation | 72 h after extubation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Airway Extubation, Ultrasonography, Ventilator Weaning