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-To Assess Value of Transthoracic Ultrasound In Predicting Post-extubation Distress in Respiratory ICU Using Ultrasound Parameters As Diaphragmatic Excursion ,Diaphragmatic,Diaphragmatic Thickness Fraction,Diaphragmatic Thickness.
Establishing the correct time to extubate mechanically ventilated patients is a crucial issue in the critical care practice. Both premature and delayed extubation prolong the duration of mechanical ventilation and the intensive care unit (ICU) length of stay and increase morbidity and mortality. Therefore, accurate prediction of post-extubation distress and the early diagnosis of the causes responsible for failure of a trial of pressure support ventilation or a trial of totally unsupported respiration are of paramount importance to improve the outcome of mechanically ventilated patients in the ICU.
The Investigators hypothesized that the use of an integrative thoracic ultrasound assessment, encompassing bedside respiratory, and diaphragm sonographic data, could accurately predict post-extubation distress in patients who succeeded in a pressure support ventilation trial. In addition, The Investigators suggest that the use of appropriate analytical methods, that is, machine-learning methods, could permit the evaluation of the specific impact of respiratory and diaphragm sonographic data on the final estimation of a likelihood of post-extubation distress .
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transthoracic Ultrasound | Device | Sonar of The Chest |
| Measure | Description | Time Frame |
|---|---|---|
| post-extubation distress | Using Transthoracic US to measure Diaphragmatic Excursion and Diaphragmatic Thickness as Predictors of Postextubation Distress during Successful Weaning Trials. | "through study completion, an average of 3 year". |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluation of different factors that affect weaning outcome as diaphragmatic dysfunction,ventilator associated pneumonia,electrolyte disturbances and so on. | Looking on Diaphragmatic function And If There is any Ventilator Associated pneumonia And Electrolyte Disturbance | Doing Transthoracic US 48 hour after Starting of Mechanical Ventilation when Patient becomes Weanable during Weaning Trials,and 48 hour Postextubation Weaning and 48 hour postextubation. |
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Inclusion Criteria:
Exclusion Criteria:
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.Any Patient Has Successful Weaning Trial above18Years old in Respiratory ICU
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Rehab Haredy Hassan, Resident Physicion | Contact | 01026128677 | rehabharedy@gmail.com | |
| Maha kamel Ghanem, prof | Contact | 01227694434 | mahaghanem@hotmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Hoda Ahmad Ali, prof | Respiratory ICU of Assiut University Hospital | Study Director |
| Ali Abdelazeem Hassan, prof | Respiratory ICU of Assiut University Hospital | Study Director |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 17166980 | Background | Frutos-Vivar F, Ferguson ND, Esteban A, Epstein SK, Arabi Y, Apezteguia C, Gonzalez M, Hill NS, Nava S, D'Empaire G, Anzueto A. Risk factors for extubation failure in patients following a successful spontaneous breathing trial. Chest. 2006 Dec;130(6):1664-71. doi: 10.1378/chest.130.6.1664. | |
| 17446786 | Result |
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Follow Up of Intubated Patients During Weaning Trials Using Transthoracic US
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| Lichtenstein DA. Point-of-care ultrasound: Infection control in the intensive care unit. Crit Care Med. 2007 May;35(5 Suppl):S262-7. doi: 10.1097/01.CCM.0000260675.45549.12. |
| 22392031 | Result | Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA, Mathis G, Kirkpatrick AW, Melniker L, Gargani L, Noble VE, Via G, Dean A, Tsung JW, Soldati G, Copetti R, Bouhemad B, Reissig A, Agricola E, Rouby JJ, Arbelot C, Liteplo A, Sargsyan A, Silva F, Hoppmann R, Breitkreutz R, Seibel A, Neri L, Storti E, Petrovic T; International Liaison Committee on Lung Ultrasound (ILC-LUS) for International Consensus Conference on Lung Ultrasound (ICC-LUS). International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012 Apr;38(4):577-91. doi: 10.1007/s00134-012-2513-4. Epub 2012 Mar 6. |
| 19017880 | Result | Boussuges A, Gole Y, Blanc P. Diaphragmatic motion studied by m-mode ultrasonography: methods, reproducibility, and normal values. Chest. 2009 Feb;135(2):391-400. doi: 10.1378/chest.08-1541. Epub 2008 Nov 18. |
| 22476448 | Result | Vivier E, Mekontso Dessap A, Dimassi S, Vargas F, Lyazidi A, Thille AW, Brochard L. Diaphragm ultrasonography to estimate the work of breathing during non-invasive ventilation. Intensive Care Med. 2012 May;38(5):796-803. doi: 10.1007/s00134-012-2547-7. Epub 2012 Apr 5. |
| 23484845 | Result | McConville JF, Kress JP. Weaning patients from the ventilator. N Engl J Med. 2013 Mar 14;368(11):1068-9. doi: 10.1056/NEJMc1300398. No abstract available. |
| 10852766 | Result | Epstein SK, Nevins ML, Chung J. Effect of unplanned extubation on outcome of mechanical ventilation. Am J Respir Crit Care Med. 2000 Jun;161(6):1912-6. doi: 10.1164/ajrccm.161.6.9908068. |
| 12684315 | Result | Shen HN, Lin LY, Chen KY, Kuo PH, Yu CJ, Wu HD, Yang PC. Changes of heart rate variability during ventilator weaning. Chest. 2003 Apr;123(4):1222-8. doi: 10.1378/chest.123.4.1222. |
| 8553271 | Result | Ueki J, De Bruin PF, Pride NB. In vivo assessment of diaphragm contraction by ultrasound in normal subjects. Thorax. 1995 Nov;50(11):1157-61. doi: 10.1136/thx.50.11.1157. |