Airway Extubation Clinical Trial
Official title:
Predicting Extubation Outcomes in Mechanically Ventilated Patients Using PW-TDI Diaphragmatic Kinematics and Traditional Ventilation Parameters: A Prospective Study
Determining the appropriate extubation timing for mechanically ventilated patients is a critical issue in the Intensive Care Unit (ICU). Early or delayed extubation may prolong mechanical ventilation and ICU stay, leading to an increased mortality rate. Currently, extubation timing relies solely on the Spontaneous Breathing Trial (SBT), but its reliability is relatively low, with a extubation failure rate ranging from 10% to 40%. Therefore, accurately predicting potential post-extubation issues and early identification of reasons for SBT trial failure are crucial for improving patient outcomes. Commonly used parameters for assessing readiness for extubation do not fully reflect organ dysfunction, and the investigators plan to utilize comprehensive techniques, including bedside lung and diaphragm ultrasound parameters, to enhance the accuracy of predicting extubation outcomes in patients who pass the SBT trial.
All patients included in the study underwent a spontaneous breathing trial (SBT) using pressure support ventilation (PSV) strategy. This strategy employed pressure support(PS)≤9 cmH2O and positive end-expiratory pressure (PEEP)≤5 cmH2O. The duration of the trial was 30 minutes, and the FiO2 level was set at the same level (≤0.5) used during mechanical ventilation. After successful completion of the spontaneous breathing trial (SBT), ultrasound images were promptly acquired, and the Rapid Shallow Breathing Index (RSBI) was calculated based on the values displayed by the ventilator . Simultaneously, the Acute Physiology and Chronic Health Evaluation II (APACHE II) score was computed and recorded. The decision to extubate, made by the attending physician (unaware of the ultrasound examination parameters), was based on clinical judgment. The primary endpoint event was extubation failure, defined as successful completion of SBT but an inability to sustain spontaneous breathing for more than 48 hours without noninvasive or invasive ventilation support. ;
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT05114551 -
ICU Predictive Score of WEaning Success in Patients At Risk of Extubation Failure
|
||
Recruiting |
NCT04708509 -
Extubation Advisor: Initial Implementation and Evaluation of a Novel Extubation Clinical Decision Support Tool
|
Phase 1 | |
Recruiting |
NCT06110390 -
High-flow Nasal Oxygen Therapy to Prevent Extubation Failure in Adult Trauma Intensive Care Patients
|
N/A | |
Completed |
NCT04356625 -
Maximum Expiratory Pressure in Induced Cough as a Predictor of Extubation Failure
|
N/A | |
Not yet recruiting |
NCT05506904 -
Liberation From Mechanical Ventilation Using Extubation Advisor Decision Support
|
Phase 1 | |
Recruiting |
NCT05999526 -
Mechanical Ventilation Reconnection for One Hour After Spontaneous Breathing Trial
|
N/A | |
Completed |
NCT02799056 -
Diaphragmatic and Pulmonary US for Extubation Success Prediction
|
||
Not yet recruiting |
NCT04266535 -
TCI vs Manually Controlled Infusion of Propofol
|
||
Enrolling by invitation |
NCT05523479 -
The Maximizing Extubation Outcomes Through Educational and Organizational Research (METEOR) Trial
|
N/A | |
Completed |
NCT01513772 -
The Effect of Dexmedetomidine on the Emergence Agitation in Nasal Surgery
|
N/A | |
Completed |
NCT03495947 -
High Flow Nasal Cannula in Immediately Post Extubation
|
||
Recruiting |
NCT03946371 -
Relation Between the Volume of Subglottic Secretion and Risk of Extubation Failure in ICU Patients (SEGEX)
|
||
Recruiting |
NCT05356299 -
Analysis of the Magnetic Tape Bandage on Respiratory Functional Effects.
|
N/A |