Critical Illness Myopathy Clinical Trial
Official title:
Diaphragm Function in Patients Acquired Weakness and Neuromyopathy in ICU: Impact on Weaning and Outcome (DIAPH-WEAK ICU)
Critical illness neuromyopathy is a common disease acquired during ICU stay leading to a
deep weakness involving the respiratory muscle work which result in a delayed weaning of
mechanical ventilation.
The main objective is to quantify the loss of diaphragm function by measuring the diaphragm
force (using the non invasive method by phrenic nerve stimulation allowing to measure the
twitch airway pressure during airway occlusion) in a selected population of patients with
critical illness neuromyopathy (defined as a MRC score < 48).
The second end points are to evaluate its incidence, the consequences on the patients
outcome (extubation success or failure; ICU stay) and to evaluate the relations between
diaphragm function (twitch airway pressure during airway occlusion, maximal inspiratory
pressure and diaphragm thickness evaluated by ultrasound) and peripheral limbs force
(evaluated by the Medical Research Council - MRC score).
Diaphragm function will be assessed through phrenic nerve stimulation allowing to measure
the twitch airway pressure during airway occlusion (expressed in cmH2O). It will be assessed
during a spontaneous breathing trial for each patient with a known critical illness
neuromyopathy. The diaphragm (thickness and course) will be studied by ultrasound assessment
as well. Peripheral limbs force will be evaluated by the MRC score. A total of 40 analysable
patients will be included.
All these measurements will be made at the time of the spontaneous breathing trial (SBT)
during the weaning phase. No modification of the clinical practices of the care should be
modified by the study. The twitch airway pressure during airway occlusion will be assessed
at the begining of the SBT. The other measurements will be performed 30 mn after the SBT if
this one will be well tolerated.
Participants will be followed for the duration of ICU stay.
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Observational Model: Cohort, Time Perspective: Prospective
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