Correlation Between Pi Max and Diaphragm Maximum Inspiratory Excursion Detected With Ultrasound During Weaning

Overview

This study evaluates the correlation between maximum inspiratory pressure (Pi max) and the diaphragm maximum inspiratory excursion measured with ultrasound during the weaning from invasive mechanical ventilation.

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: April 1, 2024

Interventions

  • Diagnostic Test: diaphragm ultrasound
    • For each patient intubated and ventilated in our ICU we will performed diaphragm ultrasound during the weaning process. We will performed the measurement of diaphragmatic maximum excursion during a maximal inspiration using an abdominal standard preset with M-mode, with the so called anatomical M-mode. We will put the probe in the right subcostal window to use the hepatic window to assess the movement of the diaphragm. We will performed the measure of the diaphragm excursion with patient in semi-recumbent position and through a transhepatic transverse oblique scan while the patient is on mechanical ventilation and undergo a Pimax maneuver, that consists in a temporary occlusion of the airway with an expiratory pause. We will performed the measure three times, and we will take into account the best one made by the patient.

Arms, Groups and Cohorts

  • case group
    • diaphragm ultrasounds during weaning and Pimax measures

Clinical Trial Outcome Measures

Primary Measures

  • Pimax and diaphragm inspiratory excursion
    • Time Frame: 4 months
    • To assess the correlation between maximum inspiratory pressure (Pi max) and the diaphragm maximum inspiratory excursion measured with ultrasound.

Secondary Measures

  • Predicting value of diaphragm excursion
    • Time Frame: 4 months
    • To assess the predicting value of the diaphragm maximum inspiratory excursion measured with ultrasound for the weaning success.
  • Combination index prediction for weaning
    • Time Frame: 4 months
    • To assess if the diaphragm maximum inspiratory excursion measured with ultrasound alone or in combination with other index (RSBI, Δtdi%) can predict the weaning success.

Participating in This Clinical Trial

Inclusion Criteria

  • Age > 18 years. – Invasive Mechanical Ventilation > 24 hours. – Readiness for weaning (following clinician decision made according to recent guidelines). Exclusion Criteria:

  • Impossibility to perform an echography.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Corporacion Parc Tauli
  • Provider of Information About this Clinical Study
    • Principal Investigator: Candelaria de Haro, MD – Corporacion Parc Tauli

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