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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 (ΔP0.1 and ΔPocc). These parameters will be measured immediately before ('baseline') the SBT, as well as 2 minutes ('early' assessment), 15 ('intermediate' assessment) and 30 minutes ('late' assessment) after the beginning of the SBT.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| adult patients undergoing mechanical ventilation |
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| Measure | Description | Time Frame |
|---|---|---|
| changes of diaphragmatic longitudinal strain between baseline and during Spontaneous breathing trial | diaphragmatic longitudinal strain is LSdi Spontaneous breathing trial is SBT | 7 days |
| changes of diaphragmatic longitudinal strain strain rate between baseline and during Spontaneous breathing trial | diaphragmatic longitudinal strain strain rate is LSRdi Spontaneous breathing trial is SBT | 7 days |
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Inclusion Criteria:
Exclusion Criteria:
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Consecutive adult patients (≥18 years old) undergoing mechanical ventilation for at least 24h (regardless of the reason of intubation) and fulfilling criteria for an SBT will be included in the study. Briefly, to be eligible for an SBT, patients will have to (i) be able to trigger ventilator breaths with a reasonable level of assistance, (ii) lack of severe impairment in gas exchange, and (iii) 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.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Clément Brault, MD | Contact | 03 22 08 89 09 | brault.clement@chu-amiens.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Amiens | Recruiting | Amiens | 80480 | France |
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| ID | Term |
|---|---|
| D013180 | Sprains and Strains |
| ID | Term |
|---|---|
| D014947 | Wounds and Injuries |
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