the Effect of Doxapram on Diaphragmatic Excursion(DE) During Weaning From Mechanical Ventilation.
the Effect of Doxapram on Diaphragmatic Excursion(DE) During Weaning From Mechanical Ventilation :a Randomized Double Blinded Study.
The goal of this clincal trial is to learn if doxapram is effective in weaning in adults on mechanical ventilation.
The objectives of this study:
- Evaluate the effect of doxapram on diaphragmatic function (assessed by DE)during weaning from mechanical ventilation.
- Assess the impact of doxapram on respiratory muscle sterngth.
- Mointor adverse effects associated with doxapram administration.
Researchers will compare expermental group(intervenous doxapram during weaning)with control group(saline infusion)during weaning.
The patients who fulfull criteria of weaning will be subjected to our clincal trial and put on spontanous breathing trial for 120mins using positive end expiratory pressure (peep)5 cmh2o,pressure support 5cm h2o and fio2 0.3.By the end of the SBTthe patient will be extubated if ventilator parameters and vital signs were maintained within 20%of baseline values.
The patients will be followed up after extubation and afailed weaning will be defined as the neeed for either invasive or non invasive ventilation for 72 after extubation or failed SBT.
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
研究の種類
研究の種類
入学 (推定)
入学
段階
段階
- フェーズ 4
連絡先と場所
研究連絡先
研究連絡先
- 名前:ahmed mekhemar Mekhemar, doctor
- 電話番号:+201122296845
- メール:totaldamned@gmail.com
参加基準
適格基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Adults (≥18 years) on mechanical ventilation for >48 hours.
- Deemed ready for weaning by the clinical team: Defined as RSBI <105, P/F ratio >200, hemodynamic stability.
- Stable hemodynamics and adequate oxygenation (PaO₂/FiO₂ >150)
Exclusion Criteria:
Severe neurological impairment :Defined as GCS ≤8 or spinal cord injury above T5 .
- Known hypersensitivity to doxapram.
- Pregnancy or lactation.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:4倍
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
|---|---|
|
実験的:Intervenous Doxapram During Weaning.
Patient in this arm will receive intervenous doxapram during weaning from mechanical ventilation in addition to standard weaning care.Diaphragmatic excursion and respiratory parameters will be assessed during weaning process.
|
Doxapram is used as a respiatory stimulant intended to enhance respiratory drive and diaphragmatic activity durig ventilator weaning.
|
|
介入なし:Standard Weaning Care.
Paients in this arm will receive standard weaning care without intervenous doxapram infusion.Diaphragmatic excursion and respiratory parameters will be assesseed during the weaning process.
|
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
時間枠 |
|---|---|
|
- Diaphragmatic excursion (DE) measured by ultrasound.
時間枠:Baseline(immediately before initiation of weaning trial) ,and at 15 minutes,60 minutes,and 120 minutes after initiation of weaning trial.
|
Baseline(immediately before initiation of weaning trial) ,and at 15 minutes,60 minutes,and 120 minutes after initiation of weaning trial.
|
二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Maximal Inspiratory Pressure(MIP)
時間枠:Baseline and during weaning trial up to 120 minutes.
|
Baseline and during weaning trial up to 120 minutes.
|
|
|
Weaning Success Rate
時間枠:Within 48hr after extubation.
|
Successful liberation from mechanical ventilation without the need for reintubation or noninvasive ventilatory support.
|
Within 48hr after extubation.
|
その他の成果指標
その他の成果指標
結果測定 |
時間枠 |
|---|---|
|
Duration of ICU Stay
時間枠:From ICU admission until ICU discharge, assessed up to 30 days.
|
From ICU admission until ICU discharge, assessed up to 30 days.
|
協力者と研究者
出版物と役立つリンク
一般刊行物
- Esteban A, Anzueto A, Frutos F, Alia I, Brochard L, Stewart TE, Benito S, Epstein SK, Apezteguia C, Nightingale P, Arroliga AC, Tobin MJ; Mechanical Ventilation International Study Group. Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA. 2002 Jan 16;287(3):345-55. doi: 10.1001/jama.287.3.345.
- Helmy MA, Magdy Milad L, Osman SH, Ali MA, Hasanin A. Diaphragmatic excursion: A possible key player for predicting successful weaning in patients with severe COVID-19. Anaesth Crit Care Pain Med. 2021 Jun;40(3):100875. doi: 10.1016/j.accpm.2021.100875. Epub 2021 Apr 30. No abstract available.
- Adolf Helmy M, Magdy Milad L, Hasanin A, Mostafa M. The novel use of diaphragmatic excursion on hospital admission to predict the need for ventilatory support in patients with coronavirus disease 2019. Anaesth Crit Care Pain Med. 2021 Dec;40(6):100976. doi: 10.1016/j.accpm.2021.100976. Epub 2021 Nov 5.
- Roesthuis LH, van der Hoeven JG, van Hees HWH, Schellekens WM, Doorduin J, Heunks LMA. Recruitment pattern of the diaphragm and extradiaphragmatic inspiratory muscles in response to different levels of pressure support. Ann Intensive Care. 2020 May 29;10(1):67. doi: 10.1186/s13613-020-00684-6.
- Wu JQ, Wang YX, Su D, Shao TH, Ding XX, Sun T, Cui N, Yu ZB. EFFECTS OF LEVOSIMENDAN ON DIAPHRAGMATIC DYSFUNCTION IN PATIENTS WITH SEPSIS. Shock. 2024 Jul 1;62(1):63-68. doi: 10.1097/SHK.0000000000002372. Epub 2024 Apr 8.
- Moser KM, Luchsinger PC, Adamson JS, McMahon SM, Schlueter DP, Spivack M, Weg JG. Respiratory stimulation with intravenous doxapram in respiratory failure. A double-blind co-operative study. N Engl J Med. 1973 Mar 1;288(9):427-31. doi: 10.1056/NEJM197303012880901. No abstract available.
- Eltrabili HH, Hasanin AM, Soliman MS, Lotfy AM, Hamimy WI, Mukhtar AM. Evaluation of Diaphragmatic Ultrasound Indices as Predictors of Successful Liberation From Mechanical Ventilation in Subjects With Abdominal Sepsis. Respir Care. 2019 May;64(5):564-569. doi: 10.4187/respcare.06391. Epub 2019 Jan 22.
- de Waal CG, Hutten GJ, Kraaijenga JV, de Jongh FH, van Kaam AH. Doxapram Treatment and Diaphragmatic Activity in Preterm Infants. Neonatology. 2019;115(1):85-88. doi: 10.1159/000493359. Epub 2018 Oct 23.
- Roesthuis L, van der Hoeven H, Sinderby C, Frenzel T, Ottenheijm C, Brochard L, Doorduin J, Heunks L. Effects of levosimendan on respiratory muscle function in patients weaning from mechanical ventilation. Intensive Care Med. 2019 Oct;45(10):1372-1381. doi: 10.1007/s00134-019-05767-y. Epub 2019 Oct 1.
研究記録日
主要日程の研究
研究開始 (推定)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
その他の研究ID番号
- effect of doxapram in weaning.
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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