Tissue Doppler Ultrasound During Spontaneous Breathing and Non-invasive Ventilation in the Post-extubation Period.
Diaphragm Performance Evaluation With Tissue Doppler Ultrasound Examination During Spontaneous Breathing in Facial Mask and During Non-invasive Ventilation in the Post-extubation Period.
Lead Sponsor: Azienda Ospedaliero Universitaria Maggiore della Carita
|Source||Azienda Ospedaliero Universitaria Maggiore della Carita|
The aim of the present investigation will be to evaluate diaphragmatic excursion velocity during non-invasive ventilation and spontaneous breathing at both inspiration and expiration.
this analysis will be performed through diaphragmatic tissue Doppler assessment.
Early weaning from invasive ventilation, in patients admitted to intensive care, is associated with a marked reduction in ventilator-associated pneumonia, length of stay in intensive care unit and hospital, total duration of mechanical ventilation and decrease in overall mortality. Moreover, in case of need of protected extubation, non-invasive ventilation has allowed to prevent re-intubation and decrease hospital mortality compared to the simple administration of oxygen through a facial mask, in particular when applied immediately after extubation.
The diaphragmatic tissue doppler imaging (TDI) is an ultrasonographic technique derived from ultrasound evaluation of the heart's motility. It can be easily used on the diaphragm to calculate the speed of muscles displacement that could be associated with patient's respiratory drive.
The aim of the study is the evaluation of the diaphragmatic excursion velocity variations using diaphragmatic tissue doppler, measured in venturi mask and non-invasive ventilation in the post-extubation period, in order to compare the diaphragm stress variations during the two different modes.
Method Patients after extubation will be randomly submitted to a spontaneous breathing test in venturi mask and in facemask or helmet NIV.
Each trial will last 20 minutes. During the last minute of each trial a tissue doppler diaphragm examination will be performed to assess the speed speed of muscle displacement, acceleration and deceleration.
Inclusion criteria: invasive mechanical ventilation > 24h with consequent extubation.
Exclusion criteria: refusal to grant consent, pregnancy, age < 18 years, haemodynamic instability, difficult management of secretions, required inotropic and / or vasoactive drugs at high doses.
During the study, vital parameters will be given.
|Start Date||April 1, 2019|
|Completion Date||April 1, 2020|
|Primary Completion Date||December 12, 2019|
Intervention Type: Other
Intervention Name: Post-extubation TDI
Description: A diaphragmatic tissue Doppler evaluation will be performed during non-invasive ventilation and spontaneous breathing trial applied in random sequence. Each trial will last 20 minutes. During the last minute of each trial a tissue doppler diaphragmatic examination will be performed to assess the speed of diaphragmatic displacement during inspiration and expiration.
Arm Group Label: diaphragmatic tissue doppler evaluation
Inclusion Criteria: - invasive mechanical ventilation > 24h with consequent extubation Exclusion Criteria: - refusal to grant consent - pregnancy - age >18 years - haemodynamic instability - difficult management of secretions - required inotropic and / or vasoactive drugs at high doses
- invasive mechanical ventilation > 24h with consequent extubation
- refusal to grant consent
- age >18 years
- haemodynamic instability
- difficult management of secretions
- required inotropic and / or vasoactive drugs at high doses
Minimum Age: 18 Years
Maximum Age: N/A
Healthy Volunteers: No
Last Name: Gianmaria Cammarota, MD,PHD
Email: [email protected]
Type: Principal Investigator
Investigator Affiliation: Azienda Ospedaliero Universitaria Maggiore della Carita
Investigator Full Name: Gianmaria Cammarota
Investigator Title: Principal Investigator, MD of ICU staff
|Has Expanded Access||No|
|Number Of Arms||1|
Label: diaphragmatic tissue doppler evaluation
Description: A tissue Doppler evaluation, using a sectorial probe, will be performed by analyzing the diaphragmatic displacement velocity during inspiration and expiration randomly assessed in spontaneous breathing with Venturi Mask and in Non-invasive ventilation with a helmet or facial mask
|Study Design Info||
Intervention Model: Single Group Assignment
Intervention Model Description: Single Group Assignment
Primary Purpose: Treatment
Masking: None (Open Label)