Role of Ultrasound Assessment of Parasternal Intercostal Muscle Thickness During Weaning From Mechanical Ventilation

Study Overview
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Brief Summary
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Assessment of the the parasternal intercostal muscles thickness by the ultrasonography as a weaning predictor of the mechanically ventilated patients

Detailed Description
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impact of parasternal muscle thickness on the weaning process of the mechanically ventilated patients in ICU

Official Title
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Role of Ultrasound Assessment of Parasternal Intercostal Muscle Thickness During Weaning From Mechanical Ventilation

Conditions
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Parasternal Intercostal Muscle Thickness, Weaning From Mechanical Ventilation

Intervention / Treatment
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* Diagnostic Test: Parasternal intercostal muscles thickness ultrasound indicies


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Any patient invasively mechanically ventilated at least 24 hours on a pressure support mode who is clinically stable and ready to undergo a spontaneous breathing trial. All patients will be: Alert. Afebrile. Adequate cough with absence of excessive tracheobronchial secretion. Fraction of inspired oxygen (FIO2) of <50%. PEEP ≤8 cmH2O. PaO2/FiO2 > 150. pH ≥7.35 and ≤7.45. Respiratory rate (RR) ≤35 breaths/min. Hemodynamically stable in the absence of vasopressors. Stable metabolic and endocrinal status. Euglycemic state. Adequate mentation (no sedation or stable neurologic patient). Exclusion Criteria: Diaphragmatic paralysis (detected by ultrasonography).Patients&Methods. 6 Pregnant women. Age: >= 18 years. Surgical dressings over measurement point which would preclude ultrasound exam. Underweight patients (Body mass index <18.5 kg/m2). Morbidly obese patient (Body mass index ≥ 40 kg/m2). Primary neuro-muscular diseases. Central coditions with depressed central respiratory drive (encephalitis, and brainstem haemorrhage/ischaemia). Repiratory conditions with reduced pulmonary compliance (interstitial lung disease, pulmonary hemorrhage, and diffuse pulmonary infiltrates) or reduced chest wall compliance (kyphoscoliosis). Cardiac conditions with high risk of weaning induced pulmonary edema (congestive heart failure, cyanotic heart diease, pulmonary hypertension, and ischemic heart diease). Addict patients. Patients with psychiatric disease.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 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 |
| --- | --- |
| Mechanical Ventilated patients<br>All patients are invasively mechanically ventilated at least 24 hours, and are clinically stable as ready to undergo a spontaneous breathing trial. | Diagnostic Test: Parasternal intercostal muscles thickness ultrasound indicies<br>* Parasternal intercostal muscles thickness ultrasound indicies includes: Parasternal Intercostals Thickness Fraction. Parasternal Intercostals Thickness at the End of Inspiration. Parasternal Intercostals thickness at the End of Expiration.<br>* Other names: Diaphragmatic thickness;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the thickness fraction of the parasternal intercostal muscle as a predictor of successful spontaneous breathing trials | The primary outcome is to assess the change of the parasternal intercostal muscles thickness at end of expiration and end of inspiration to verify the thickness fraction of the parasternal intercostal muscle as a predictor of successful spontaneous breathing trials. | Before the start spontaneous breathing trial | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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mechanical ventilation, parasternal muscle thickness