Correlation Between Muscle Thickness and Inflammation With Ventilator Use in Critically Ill Patients

Overview

Decrease thickness of diaphragm muscle, cross-sectional area of rectus femoris and biceps brachii muscle, and increase in CRP would affect ventilator length of use in critically ill patients in ICU

Full Title of Study: “Correlation Between Muscle Thickness and Inflammation With Ventilator Length of Use in Critically Ill Patients: Study on Diaphragm Thickness, Rectus Femoris and Biceps Brachii Cross-sectional Area, and C-reactive Protein Level”

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: January 31, 2019

Interventions

  • Other: Diaphragm thickness
    • measured at apposition zone using ultrasonography in mm
  • Other: Cross-sectional area of rectus femoris muscle
    • measured at lower one-third line between Spina iliaca anterior inferior (SIAI) and upper border femur patella using ultrasonography in cm^2
  • Other: Cross-sectional area of biceps brachii
    • measured at biceps brachii muscle using ultrasonography in cm^2
  • Diagnostic Test: C-Reactive Protein (CRP) Level
    • quantitative CRP using ELISA method in mcg/mL

Arms, Groups and Cohorts

  • Ventilator length of use
    • measured in days

Clinical Trial Outcome Measures

Primary Measures

  • Correlation between changes in diaphragm thickness with ventilator length of use
    • Time Frame: 30 days from admission
    • Correlation between changes in diaphragm thickness with ventilator length of use: < 7 days or >7 days
  • Correlation between changes in cross-sectional area of rectus femoris muscle with ventilator length of use
    • Time Frame: 30 days from admission
    • Correlation between changes in cross-sectional area of rectus femoris muscle with ventilator length of use: < 7 days or >7 days
  • Correlation between changes in cross-sectional area of biceps brachii muscle with ventilator length of use
    • Time Frame: 30 days from admission
    • Correlation between changes in cross-sectional area of biceps brachii muscle with ventilator length of use: < 7 days or >7 days
  • Correlation between changes in quantitative C-reactive protein (CRP) level with ventilator length of use
    • Time Frame: 30 days from admission
    • Correlation between changes in quantitative C-reactive protein (CRP) level with ventilator length of use: < 7 days or >7 days

Secondary Measures

  • Ventilator length of use
    • Time Frame: 30 days from admission
    • duration of first ventilator use until patient is extubated or deceased: <7 days or >7 days
  • Changes in diaphragm thickness
    • Time Frame: 5 days from admission
    • Measurement of diaphragm thickness from day 1 admission to ICU using ventilator to day 5 in mm Score for changes in diaphragm thickness: 0 : no changes : decrease thickness of <20% : decrease thickness of >20%
  • Changes in cross-sectional area of rectus femoris muscle
    • Time Frame: 5 days from admission
    • Measurement of cross-sectional area of rectus femoris muscle from day 1 admission to ICU using ventilator to day 5 in cm^2 Score for changes in diaphragm thickness: 0 : no changes : decrease cross-sectional area of <20% : decrease cross-sectional area of >20%
  • Changes in cross-sectional area of biceps brachii muscle
    • Time Frame: 5 days from admission
    • Measurement of cross-sectional area of biceps brachii muscle from day 1 admission to ICU using ventilator to day 5 in cm^2 Score for changes in diaphragm thickness: 0 : no changes : decrease cross-sectional area of <20% : decrease cross-sectional area of >20%
  • Changes in quantitative C-reactive protein (CRP) levels
    • Time Frame: 5 days from admission
    • Measurement of quantitative CRP from day 1 admission to ICU using ventilator to day 5 in mcg/mL Score for changes in diaphragm thickness: 0 : no changes : increase in quantitative CRP <50% : increase in quantitative CRP >50%

Participating in This Clinical Trial

Inclusion Criteria

  • Patients who had Modified Rankin Score < 4 in 1 month before admitted into ICU Exclusion Criteria:

  • Pregnant women – Patients who had intubation more than 24 hours before admitted at ICU Cipto Mangunkusumo Hospital – Patients who had a history or prior to thoracic or heart surgery 14 days before admission – Patients who had severe peripheral muscle dysfunction – Patients who had a history of admission in hospital for more than 2 weeks on the last 3 months – Patients who predicted will be using ventilator for less than 4 days – Patients who suffered acute respiratory distress syndrome (ARDS) with a ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2) less than 200 – Patients who declined to participate in this study

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Indonesia University
  • Provider of Information About this Clinical Study
    • Principal Investigator: Dita Aditianingsih, MD, PhD, Anesthesiologist Consultant – Indonesia University

References

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