Clinical trial NCT06465082: Diaphragmatic Thickening Fraction as a Predictor of Successful Weaning
Official title: Role of Diaphragmatic Thickening Fraction as a Predictor of Successful Weaning From Mechanical Ventilation
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Weaning From Mechanical Ventilation
Keywords: mechanical ventilation.
diaphragmatic thickening Fraction
Lead sponsor: Mansoura University Hospital
Sponsor class: OTHER
First posted: 2024-06-18
Enrollment: 55
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_CROSSOVER
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Adult patients \>18 years old, who are in need for mechanical ventilation as: Life threatening hypoxia, Respiratory rate \> 30 breath/min, Disturbed conscious level.

Brief summary: The aim of this study is to assess the validity of the diaphragmatic thickening Fraction measured by ultrasound as a predictor for successful weaning from mechanical ventilation.

Detailed description: Timing is critical for proper weaning for patients undergoing mechanical ventilation; if this is performed prematurely complications can include increased cardiovascular and respiratory stress, CO2 retention and hypoxemia. However, unnecessary delay in weaning can also cause a number of side-effects.Weaning outcomes have been assessed by several indices. Variables such as minute ventilation, Pao2/Fio2, rapid shallow breathing index and static compliance have all been used, with variable predictive values. Previous studies have proved that diaphragmatic dysfunction is one of the main etiologies of difficult weaning, because the diaphragm progressively weakens with mechanical ventilation.Methods used to assess diaphragm function, such as fluoroscopy, phrenic nerve stimulation, measurement of trans-diaphragmatic pressure and dynamic magnetic resonance imaging of the diaphragm, all have limitations. These include ionizing radiation exposure, low availability, invasiveness and necessity for patient transportation. Conversely, the use of ultrasound is safe, non-invasive, avoids radiation side-effects, and is available at the bedside.The aim of this study is to assess the validity of the diaphragmatic thickening Fraction measured by ultrasound as a predictor for successful weaning from mechanical ventilation.

Eligibility criteria: Inclusion Criteria:

* Adult patients \>18 years old, who are in need for mechanical ventilation as: Life threatening hypoxia, Respiratory rate \> 30 breath/min, Disturbed conscious level.

Exclusion Criteria:

* Age \<18 years.
* Pregnancy
* Surgical incisions likely to interfere with ultrasound examination.
* Hepato-splenomegaly, Ascites
* Neuromuscular disease as Myasthenia gravis, kypho-scoliosis
* Diaphragmatic Paralysis (paralyzed diaphragm exhibiting abnormal paradoxical movement, i.e., moving in a cranial direction during inspiration

Primary outcomes:
measure: Diaphragmatic thickening Fraction as predictor for weaning from mechanical ventilation.
timeFrame: Baseline and after 6 month
Secondary outcomes:
Other outcomes:
Locations:
city: Mansoura
country: Egypt
facility: Mohamed AbdElmoniem
Study officials:
affiliation: Mansoura University
name: Mohamed AbdElmoniem
role: PRINCIPAL_INVESTIGATOR
References: