Respiratory Failure Clinical Trial
Official title:
Contribution of Mechanical Insufflation-Exsufflation in Preventing Respiratory Failure Post Extubation in Patient With Critical Care Neuromyopathy
Respiratory failure after extubation is a relevant consequence of poor airway clearance due
to respiratory muscle weakness and respiratory failure after extubation and reintubation is
associated with increased morbidity and mortality.
the study will evaluate the contribution of Mechanical Insufflation-Exsufflation (MI-E) in
Preventing Respiratory Failure After Extubation as compared manually assisted coughing
Critical Care Neuromyopathy (CCN) occur in 25% of patient in Intensive Care Unit (ICU).
Respiratory failure after extubation is a relevant consequences of poor airway clearance due
to respiratory muscle weakness. Respiratory failure is a major cause for reintubation which
increase severity of illness, this is an independent risk factor for nosocomial pneumonia,
increased hospital stay and mortality. Currently, respiratory physiotherapy includes, manual
expiration assist often associated with nasotracheal aspiration. Despite of this care,
respiratory failure occur in 30% of patients within 48 after planned extubation. MI-E has
been evaluated for neuromuscular disease patient, and increase peak cough flow and the airway
clearance. So the beneficials effects of MI-E should be confirmed in a trial in this specific
population.
We planned to conduct a study evaluating the efficacy of MI-E in the prevention of extubation
failure and mortality in these patients. If no signs of respiratory failure appeared after
120 min of a spontaneous breathing trial, patients will be extubated and randomly allocated
after extubation to MI-E group or control group. The clinical follow-up will be as follow:
the incidence of extubation failure, the reintubation, the ICU or 28-day survival,90-day
survival, ICU length of stay.
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