Role Of Transthoracic Ultrasound in Predicting Post-extubation Distress During Successful Weaning

Study Overview
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Brief Summary
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-To Assess Value of Transthoracic Ultrasound In Predicting Post-extubation Distress in Respiratory ICU Using Ultrasound Parameters As Diaphragmatic Excursion ,Diaphragmatic,Diaphragmatic Thickness Fraction,Diaphragmatic Thickness.

Detailed Description
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Establishing the correct time to extubate mechanically ventilated patients is a crucial issue in the critical care practice. Both premature and delayed extubation prolong the duration of mechanical ventilation and the intensive care unit (ICU) length of stay and increase morbidity and mortality. Therefore, accurate prediction of post-extubation distress and the early diagnosis of the causes responsible for failure of a trial of pressure support ventilation or a trial of totally unsupported respiration are of paramount importance to improve the outcome of mechanically ventilated patients in the ICU. The Investigators hypothesized that the use of an integrative thoracic ultrasound assessment, encompassing bedside respiratory, and diaphragm sonographic data, could accurately predict post-extubation distress in patients who succeeded in a pressure support ventilation trial. In addition, The Investigators suggest that the use of appropriate analytical methods, that is, machine-learning methods, could permit the evaluation of the specific impact of respiratory and diaphragm sonographic data on the final estimation of a likelihood of post-extubation distress .

Official Title
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Role Of Transthoracic Ultrasound in Predicting Post-extubation Distress During Successful Weaning

Conditions
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Transthoracic US

Intervention / Treatment
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* Device: Transthoracic Ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients above 18 yrs. old who admitted to respiratory ICU and mechanically ventilated due to chest diseases and passed weaning trials Exclusion Criteria: Pregnancy. Neuromuscular disorders. Psychiatric instability. Uncontrolled cardiovascular disease. Tracheostomy. patints with failed weaning trials. Inability to provide informed consent.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Device: Transthoracic Ultrasound|Sonar of The Chest|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| post-extubation distress | Using Transthoracic US to measure Diaphragmatic Excursion and Diaphragmatic Thickness as Predictors of Postextubation Distress during Successful Weaning Trials. | through study completion, an average of 3 year. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evaluation of different factors that affect weaning outcome as diaphragmatic dysfunction,ventilator associated pneumonia,electrolyte disturbances and so on. | Looking on Diaphragmatic function And If There is any Ventilator Associated pneumonia And Electrolyte Disturbance | Doing Transthoracic US 48 hour after Starting of Mechanical Ventilation when Patient becomes Weanable during Weaning Trials,and 48 hour Postextubation Weaning and 48 hour postextubation. |