Ultrasound Diagnostic for Diaphragmatic Dysfunction in Reanimation

Ultrasound Diagnostic for Diaphragmatic Dysfunction in Reanimation and Influence Over Mechanical Ventilation Weaning Period

Extubation is a crucial step when patients are being weaned from mechanical ventilator support. Indeed, the patient has to face an increasing burden imposed to the ventilation system. The ability to overcome this event will determine the patient survival. A warning signal could be very useful is this situation. 2 recent studies have shown that measuring diaphragmatic cupolas and muscular fibers thickening fraction could help to spot a population with a high risk of "diaphragmatic weakness", characterized by a high failure extubation rate. This study aims to verify that this kind of group of patients does exist.

Inclusion Criteria:

• Successful spontaneous breathing trial and extubation expected on the same day and 1 of the following criteria :
• Age > 65
• Mechanical ventilation during > 7 days
• Cardiac history (ischemic, rhythmic or valve cardiopathy)
• Respiratory history (documented or likely chronic respiratory failure)

Exclusion Criteria:

• Patient who is tracheotomized
• Peripheric neuromuscular disease (myasthenia, myopathy)
• Surgery circumstances that could affect the quality of the ultrasound exam (drains or bandages)
• Pregnant woman
• Age < 18