Ultrasound Evaluation of Abdominal Muscle Thickness During Mechanical Ventilation

Study Overview
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Brief Summary
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Weakness of respiratory muscles is frequent after several days of mechanical ventilation. Thereby an acquired diaphragm weakness has been demonstrated, linked to an atrophy which may be identified by a decrease of muscle thickness in echography. This study aims to evaluate with ultrasound the variation of thickness of abdominal muscles after 7 days of mechanical ventilation.

Detailed Description
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Weakness of respiratory muscles is frequent after several days of mechanical ventilation. Thereby an acquired diaphragm weakness has been demonstrated, linked to an atrophy which may be identified by a decrease of muscle thickness in echography. Weakness of expiratory muscles is also frequent after 7 days of mechanical ventilation, however his cause is not clear: is it present at admission notably in elderly patients, or acquired on mechanical ventilation ? Ultrasound allows to measure the thickness of abdominal muscles which correlates with their strength. This study aims to evaluate with ultrasound the variation of thickness of abdominal muscles after 7 days of mechanical ventilation.

Official Title
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Ultrasound Evaluation of Abdominal Muscle Thickness During Mechanical Ventilation

Conditions
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Ventilation Therapy; Complications

Intervention / Treatment
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* Device: Ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient affiliated or entitled to a social security plan Expected duration of mechanical ventilation > 7 days Trusted person/relative who has signed a consent to participate in the study Exclusion Criteria: Patient with a pre-existing neuromuscular pathology No access to ultrasound Windows (dressing, drainages...) Patient transferred from another intensive care unit Patient Under guardianship or curators

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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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Patients under mechanical ventilation<br>Ultrasound evaluation of the variation of thickness of abdominal muscles after 7 days of mechanical ventilation | Device: Ultrasound<br>* Ultrasound evaluation of the variation of thickness of abdominal muscles after 7 days of mechanical ventilation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Thickness of the abdominal muscles (mm) | It is the sum of the thickness of rectus abdominal muscle + external oblique + internal oblique + transverse muscles. | Day 7 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Thickness of the rectus abdominal muscles (mm) | Thickness of the rectus abdominal muscles (mm) by ultrasound measurement. | Day 7 | 
| Thickness of the external oblique abdominal muscles (mm) | Thickness of the external oblique abdominal muscles (mm) by ultrasound measurement | Day 7 | 
| Thickness of the internal oblique abdominal muscles (mm) | Thickness of the internal oblique abdominal muscles (mm) by ultrasound measurement | Day 7 | 
| Thickness of the transverse abdominal muscles (mm) | Thickness of the transverse abdominal muscles (mm) by ultrasound measurement | Day 7 | 
| Diaphragmatic thickness (mm) | Diaphragmatic thickness (mm) measured by ultrasound | Day 7 | 
| Diaphragmatic thickness (mm) | Diaphragmatic thickness (mm) measured by ultrasound | Immediately after the successful extubation of the patient | 
| Number of day with a contraction of the transverse abdominal muscle | Ultrasound search for a contraction of the transverse abdominal muscle during the morning clinical examination each day from D1 to D7 | From day 1 to day 7 | 
| Caught peak expiratory flow (CPEF) (cmH2O) | Only for conscious patients, responding to the simple command and tolerating minimal respiratory support (inspiratory support 7 cmH20, Pep 0 cmH20) caught peak expiratory flow (CPEF) measurement | Day 7 | 
| Maximum expiratory pressure (l/min) | Only for conscious patients, responding to the simple command and tolerating minimal respiratory support maximum expiratory pressure (PE max) measurement | Day 7 | 
| Thickness of the external oblique abdominal muscle (mm) | External oblique abdominal muscle by ultrasound measurement | Immediately after the successful extubation of the patient | 
| Thickness of the internal oblique abdominal muscle (mm) | Internal oblique abdominal muscle by ultrasound measurement | Immediately after the successful extubation of the patient | 
| Thickness of the transverse abdominal muscle (mm) | Transverse abdominal muscle by ultrasound measurement | Immediately after the successful extubation of the patient | 
| Thickness of the rectus abdominal muscle (mm) | Rectus abdominal muscle by ultrasound measurement | Immediately after the successful extubation of the patient | 
| Number of day between day 7 and successful extubation day (days) |  | From Day 7 to the day when the patient will be extubated successfully | 
| Duration of sedation (Day) |  | At intensive care unit discharge | 
| Duration of curarization (Day) |  | At intensive care unit discharge | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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abdominal muscles, ultrasound