Weaning From Mechanical Ventilation Clinical Trial
Official title:
Assessment of the Evolution of Force and Endurance of Inspiratory Muscles in Intubated and Mechanically-ventilated ICU Patients With Difficult Weaning
Ventilator-induced diaphragmatic dysfunction appears to contribute to slow weaning from
mechanical ventilation. Several trials of inspiratory muscle training to facilitate weaning
in intensive care have been performed, with inconsistent results, utilizing different methods
of IMT in different populations.
To perform the best IMT program, we need to know the physio-pathology of the diaphragm in
difficult to wean patients.
This study proposes to discriminate the two main characteristics of the inspiratory muscles:
strength and endurance.
By analyzing the evolution of strength and endurance during all the weaning period, we want
to know which characteristic has the more deficiency to adapt in a second time an effective
program of IMT.
The main objective of this study is to determinate which characteristic of inspiratory
muscles between strength and endurance has more deficiency in difficult to wean patients. In
a second time, the results of this study will help to choose the best IMT program to assess
his impact on the weaning time.
We are going to conduct an interventional trial because of Peak Pressure measure, which is
not measure in care practice. Following 18h of invasive mechanical ventilation in a
controlled mode, the failure of the first single breathe trial of 2 hours and the presence of
sevrability criterias defined by the European consensus conference in 2007, 80 participants
will be included in the medical intensive care unit of Bordeaux's hospital. We'll perform
measurements of the Maximal Inspiratory Pressure and Peak Pressure from the inclusion to the
extubation.
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