Clinical trial NCT04735497: Ventilator Asynchrony as a Predictor of Weaning Failure
Official title: Patient Ventilator Asynchrony as a Predictor of Weaning Failure in Mechanically Ventilated COPD Patients
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Chronic Obstructive Pulmonary Disease(COPD)
Keywords: mechanically ventilated
weaning failure
COPD
asynchrony
Lead sponsor: Assiut University
Sponsor class: OTHER
First posted: 2021-02-03
Enrollment: 100
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: All COPD patients who were diagnosed after history ,physical examination ,radiology and pulmonary function tests and required mechanical ventilation.

Brief summary: Patient ventilator asynchrony is a common problem in mechanically ventilated patients .It is associated with adverse effects including increased work of breathing, patient discomfort, increased need for sedation, prolonged mechanical ventilation , weaning difficulties and weaning failure. 100 mechanically ventilated COPD patients were enrolled in this prospective study .Detection of patient ventilator asynchrony was done on 30-minute sessions at 12, 24, 36, and 48 hours following intubation by visual assessment of pressure, flow and volume graphs on ventilator .

Detailed description: Patient-ventilator asynchrony is defined as a lack of organization between the patient and ventilator timing of both inspiration and expiration . It is a commonly reported problem during mechanical ventilation. Thille et al. found that 24% of patients developed asynchrony in at least ten percent of their breaths, moreover they stated that the most frequent asynchronies was each of ineffective triggering and double triggering . Eighty percent of chronic obstructive pulmonary disease (COPD) patients experienced ineffective triggering, where it is considered the most frequent asynchrony in this group of patients. Asynchrony between Patient and ventilator also leads to prolonged duration of invasive ventilation, and increase possibility of weaning failure.

Both spread and intensity of asynchrony during the early phase of weaning in COPD patients has never satisfactorily described. The aim of the current study was to describe the patient-ventilator asynchrony and its impact on weaning outcome in mechanically ventilated COPD patients.

Eligibility criteria: Inclusion Criteria:

All COPD patients who were diagnosed after history ,physical examination radiology and pulmonary function tests and required mechanical ventilation.

Exclusion Criteria:

1. Age \< 18 years
2. Tracheostomy
3. Failure to trigger breaths even in cases of receiving neuromuscular blocking agents.
4. Encephalopathy which is not caused by hypercapnia or hypoxemia either post arrest or due to cerebrovascular stroke
5. Patients with unplanned weaning
6. COPD patients where intubation not related to exacerbation e.g. acute pulmonary edema.

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Primary outcomes:
measure: To study effect of different types of ventilator asynchrony on weaning in mechanically ventilated COPD patients
timeFrame: One year
Secondary outcomes:
Other outcomes:
Locations:
city: Assuit
country: Egypt
facility: Assuit University Hospital
Study officials:
affiliation: Assiut University
name: Samiaa Sadek, Ass.Lecturer
role: PRINCIPAL_INVESTIGATOR
References: