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Diaphragmatic Speckle Tracking During Spontaneous Breathing Trial

Recruitingn/aAges 18 Years - anyAllCentre Hospitalier Universitaire, Amiens
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In plain words

What the trial is, and whether it could suit you

Currently, measurement of transdiaphragmatic pressure (Pdi) using oesophageal and gastric balloons is the gold standard for the assessment of diaphragmatic effort. This technique is relatively invasive and its interpretation may be complex. The diaphragmatic longitudinal strain (LSdi) and strain rate (LSRdi) might provide additional information in the assessment of diaphragmatic effort and movement during SBT, allowing early detection of diaphragmatic dysfunction. Patients will be monitored during a 30-120 minutes SBT consisting of no assistance on the ventilator using CPAP with a pressure level of 0 cmH2O. Parameters to evaluate diaphragm function will include diaphragmatic strain (LSdi and LSRdi), diaphragmatic thickening fraction (TFdi), and airway occlusion pressure (ฮ”P0.1 and ฮ”Pocc). These parameters will be measured immediately before ('baseline') the SBT, as well as 2 minutes ('ea

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๐Ÿ“‹ Eligibility rules (as published)
Inclusion Criteria: * Consecutive adult patients (โ‰ฅ18 years old) undergoing mechanical ventilation for at least 24h (regardless of the reason of intubation) * patients fulfilling criteria for an SBT * patients will have to be able to trigger ventilator breaths with a reasonable level of assistance, * patients with lack of severe impairment in gas exchange, * patients that not require significant hemodynamic support. * Patients will be recruited by the study coordinator following completion of informed consent from the patient or legally authorized substitute decision maker. Exclusion Criteria: * Use of pressure support during the SBT. * Severe hemodynamic instability (\>30% increase in vasopressors in the last 6 hours or norepinephrine \> 0.5 ยตg/kg/min). * Severe or very severe chronic obstructive pulmonary disease (COPD) according to the GOLD criteria (stage III: FEV1 30-50% predicted; stage IV: FEV1 \< 30% predicted). * Known or suspected severe or progressive neuromuscular disorder likely to result in prolonged or chronic ventilator dependence * Clinical judgement of the attending physician.
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What it tests

  • Not listed
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Where

1 site
CHU Amiens
Amiens, France
๐Ÿค Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible โ€” always decide together with your own doctor.
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