Ultrasound Measurement of Quadriceps Shortening During Neuromuscular Electrical Stimulation in Critically Ill Patients

Study Overview
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Brief Summary
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ICU-Aw is highly prevalent (50%) among critically ill patients. Its diagnosis is usually delayed as it requires patients' awakening and collaboration to provide accurate measurement. This study aims to investigate the accuracy of an early ultrasound measurement of quadriceps shortening during neuromuscular electrical stimulation to diagnose future ICU-Aw in critically ill patients.

Official Title
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Diagnostic Accuracy of Early ulTrasound Measurement of Quadriceps Thickness During Neuromuscular EleCTrical Stimulation for the Diagnosis of ICU-acquired Weakness : an Observational Study (DETECT)

Conditions
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ICU Acquired Weakness, Quadriceps Muscle Atrophy

Intervention / Treatment
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* Diagnostic Test: Early ultrasound measurement of quadriceps shortening during neuromuscular electrical stimulation (NMES)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Mechanical ventilation for at least 24 hours Exclusion Criteria: Decision to withhold life-sustaining treatment Pregnancy Degenerative neurological pathology with disabling muscle weakness Pace Maker Inability to communicate Chronic loss of autonomy described by the patient's family Guardianship

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 |
| --- |
|Diagnostic Test: Early ultrasound measurement of quadriceps shortening during neuromuscular electrical stimulation (NMES)|NMES will be applied to the quadriceps muscle to generate muscle contraction. Ultrasound measurement of the quadriceps thickness will be provided during contraction and rest, and the shortening of the quadriceps muscle will be measured. A second measurement using Shear-wave elastography measurement will also be undertaken. The measures will be undertaken at day 1 of neuromuscular blockers liberation (if any) as well as at day 3 and day 7 for the patients that will still be received mechanical ventilation at that time.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ICU-Aw diagnosis | Measured with the Medical Research Council score (scored 0 (minimum) to 60 (maximum); with a score < 48 meaning ICU-acquired weakness) | In the 24 hours following extubation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Respiratory muscles strength | Maximal Inspiratory Pressure and Maximal Expiratory Pressure | In the 30 minutes before extubation (during spontaneous breathing trial) | 
| Cough capacity | Peak Cough Flow | In the 30 minutes before extubation (during spontaneous breathing trial) | 
| Extubation failure/success | Reintubation or death | Within 48 hours after extubation |