NCT02174029

Serial Daily Diaphragm Ultrasounds in Ventilated Patients

Serial Ultrasonographic Evaluation Of Diaphragm Thickness During Mechanical Ventilation In ICU Patients

• Status: Completed
• Phase: —
• Study type: Observational
• Enrollment: 61 (actual)
• Sponsor: Steve Reynolds · Academic / Other
• Sex: All
• Age: 19 Years
• Healthy volunteers: Not accepted

Summary

When a person is put on a breathing machine the investigators think that the breathing muscles can get weaker. The investigators are not sure how quickly this happens but in some people this leads to problems when they try to breathe on their own without the breathing machine. The diaphragm is at the bottom of a person's chest separating their lungs from what is in their belly and it is a very strong muscle. In fact, it is main muscle that one uses for breathing. An ultrasound machine is a painless way to see what is happening beneath the skin. It is safe and easy to do. Using an ultrasound the investigators are planning to measure how thick the diaphragm is and how much it changes while a person is on a breathing machine in the ICU. Getting a better understanding of this condition could lead to improved treatments that might help support patients who require a ventilator for breathing. The investigators hypothesis is that patients for whom the breathing machine is doing all of the work of breathing, will have their diaphragm thickness gradually decrease and changing to a breathing modem mode where they have to put in more effort the diaphragm thickness will start increasing again.

Detailed description

The investigators propose to expand the investigators single-centre longitudinal pilot study into a complete study in which the investigators will use B-mode ultrasonography to evaluate daily changes in diaphragm thickness in all critically ill patients on mechanical ventilation (MV) until successful weaned from MV. The impact of patient age, co-morbidities, and the use of various modes of ventilation on diaphragm thickness will be assessed. Diaphragmatic thickness and its change from baseline will be evaluated as predictors of the need for a prolonged wean (\>7days). The investigators hypothesize that in patients on mandatory mode ventilation, diaphragmatic thickness will progressively decrease. Switching from mandatory to assisted breathing modes will correlate with increases in diaphragmatic thickness.

Conditions

• Muscle Atrophy or Weakness
• Ventilator-associated Lung Injury

Interventions

Type	Name	Description
PROCEDURE	Ventilation- mandatory	Patient days during which only a mandatory ventilation mode was used and prior to this no voluntary mode was used.
PROCEDURE	Ventilation- voluntary mode only	Patient days on a voluntary mode with no preceding days with a majority of time spend on a mandatory mode
PROCEDURE	Voluntary with preceding mandatory	Patient days on a voluntary vent mode with at least one day prior during which the majority of the vent mode was mandatory.

Timeline

• Start date: 2014-06-01
• Primary completion: 2014-08-01
• Completion: 2014-09-01
• First posted: 2014-06-25
• Last updated: 2015-03-11

Locations

1 site across 1 country: Canada