Clinical trial NCT06685224: Prediction of Weaning Outcome from Mechanical Ventilation Using Ultrasound
Official title: Parasternal Intercostal Muscle Thickness Versus Ultrasound Assessment of Lung Aeration As a Predictor of Weaning from Mechanical Ventilation; a Prospective Observational Study
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Assess the Prediction of Successful SBT and Extubation of Trachea by Bedside Lung Ultrasound in Mechanically Ventilated Patients
Lead sponsor: Tanta University
Sponsor class: OTHER
First posted: 2024-11-12
Enrollment: 50
Sex: ALL
Minimum age (years): 21
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Tanta University Hospitals

Brief summary: Examine the predictive value of lung ultrasound in assessing the success of SBTs and tracheal extubation among patients receiving mechanical ventilation in the intensive care unit (ICU).


Eligibility criteria: Inclusion Criteria:

* Mechanically ventilated patients will be included in the study when the underlying disease that had required intubation is considered by the attending physician as reversed and after fulfilling the criteria of weaning (alertness, and Adequate gas exchange, normal pH levels, low and stable doses of vasoactive drugs, normal electrolyte levels, and a rapid shallow breathing index (RSBI) of 105 breaths per minute per liter or lower ) rendering the patient eligible to a first SBT.

Exclusion Criteria:

* Exclusion criteria include patients aged \< 21yrs , patients with tracheostomy, paraplegia with medullar level above T8, cardiac arrhythmias, severe ICU-acquired neuromyopathy, chronic obstructive pulmonary disease with forced expiratory volume \<50% of the theoretical predicted value, patients with planned prophylactic noninvasive ventilation after extubation, and patients who had previously failed a SBT

Primary outcomes:
measure: The aim of this prospective observational study is to evaluate the predictive value of parasternal intercostal muscle thickness vs ultrasound assessment of lung aeration for prediction of weaning outcome from mechanical ventilation
timeFrame: 6 months
Secondary outcomes:
Other outcomes:
Locations:
Study officials:
References:
citation: Formenti P, Umbrello M, Dres M, Chiumello D. Ultrasonographic assessment of parasternal intercostal muscles during mechanical ventilation. Ann Intensive Care. 2020 Sep 7;10(1):120. doi: 10.1186/s13613-020-00735-y.
citation: Bouhemad B, Mongodi S, Via G, Rouquette I. Ultrasound for "lung monitoring" of ventilated patients. Anesthesiology. 2015 Feb;122(2):437-47. doi: 10.1097/ALN.0000000000000558. No abstract available.
citation: Bouhemad B, Liu ZH, Arbelot C, Zhang M, Ferarri F, Le-Guen M, Girard M, Lu Q, Rouby JJ. Ultrasound assessment of antibiotic-induced pulmonary reaeration in ventilator-associated pneumonia. Crit Care Med. 2010 Jan;38(1):84-92. doi: 10.1097/CCM.0b013e3181b08cdb.
citation: Esteban A, Alia I, Tobin MJ, Gil A, Gordo F, Vallverdu I, Blanch L, Bonet A, Vazquez A, de Pablo R, Torres A, de La Cal MA, Macias S. Effect of spontaneous breathing trial duration on outcome of attempts to discontinue mechanical ventilation. Spanish Lung Failure Collaborative Group. Am J Respir Crit Care Med. 1999 Feb;159(2):512-8. doi: 10.1164/ajrccm.159.2.9803106.
citation: Berger D, Bloechlinger S, von Haehling S, Doehner W, Takala J, Z'Graggen WJ, Schefold JC. Dysfunction of respiratory muscles in critically ill patients on the intensive care unit. J Cachexia Sarcopenia Muscle. 2016 Sep;7(4):403-12. doi: 10.1002/jcsm.12108. Epub 2016 Mar 9.
citation: Penuelas O, Frutos-Vivar F, Fernandez C, Anzueto A, Epstein SK, Apezteguia C, Gonzalez M, Nin N, Raymondos K, Tomicic V, Desmery P, Arabi Y, Pelosi P, Kuiper M, Jibaja M, Matamis D, Ferguson ND, Esteban A; Ventila Group. Characteristics and outcomes of ventilated patients according to time to liberation from mechanical ventilation. Am J Respir Crit Care Med. 2011 Aug 15;184(4):430-7. doi: 10.1164/rccm.201011-1887OC.
citation: Boles JM, Bion J, Connors A, Herridge M, Marsh B, Melot C, Pearl R, Silverman H, Stanchina M, Vieillard-Baron A, Welte T. Weaning from mechanical ventilation. Eur Respir J. 2007 May;29(5):1033-56. doi: 10.1183/09031936.00010206.