Critical Care Ultrasound Guided Weaning

Weaning Failure Clinical Trial

Official title:

Critical Care Ultrasound Guided Weaning

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05763134
• Other study ID #: ultrasound weaning
• Status: Completed
• Start date: March 1, 2023
• Est. completion date: July 20, 2023

Study information

• Verified date: February 2023
• Source: Antalya Training and Research Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Weaning patients from the ventilator in the intensive care unit is sometimes difficult because of three main interrelated etiologies: impaired lung, heart or diaphragm function. In this context, ultrasonography performed during tests for extubation of patients may enable the diagnosis of cardiac dysfunction, loss of pulmonary aeration, diaphragm dysfunction, and venous congestion, thereby reducing the number of failures in extubation.

The combination of TTE (Trans Thoracic Echocardiography), LUS (Lung Ultrasound), DUS (Diaphragmatic ultrasound) and VEXUS (Venous excess Ultrasound) may enable the identification of the etiology of weaning failure and reduce the number of extubation failures by enabling the development of an appropriate treatment strategy. With this study, it is aimed to contribute to the literature in this sense.

Description:

The aim of this study is to reduce the number of extubation failures by defining the etiology of weaning failure and developing appropriate treatment strategies by using intensive care ultrasonography applications in combination (defining cardiac, pulmonary, diaphragmatic and venous congestion).

Most patients can be extubated after the first SBT (spontaneous Breathing Trial). A patient who fails extubation is automatically classified as difficult weaning, and intensive care professionals frequently encounter patients who are difficult to wean from mechanical ventilation.

Before performing a new SBT following a failed SBT, the cause of the failure should be determined and an appropriate treatment strategy developed.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 27
• Est. completion date: July 20, 2023
• Est. primary completion date: June 30, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 85 Years

Eligibility

Inclusion Criteria:

• Invasive mechanical ventilation > 24 hours Eligibility to weaning from mechanical ventilation

Exclusion Criteria:

• Age < 18 years old

• Severe skin lesions or infections that cannot perform ultrasound

• Severe subcutaneous emphysema that cannot perform ultrasound

• Patients with a known neuromuscular disease

• Patients with a duration of mechanical ventilation <24 hours,

• Patients with severe mitral stenosis, severe mitral regurgitation, or prosthetic mitral valve

Related Conditions & MeSH terms

• Weaning Failure

Locations

Country	Name	City	State
Turkey	Antalya Training and Research Hospital	Antalya

Sponsors (1)

Lead Sponsor	Collaborator
Antalya Training and Research Hospital

Country where clinical trial is conducted

Turkey, 

References & Publications (2)

Boles JM, Bion J, Connors A, Herridge M, Marsh B, Melot C, Pearl R, Silverman H, Stanchina M, Vieillard-Baron A, Welte T. Weaning from mechanical ventilation. Eur Respir J. 2007 May;29(5):1033-56. doi: 10.1183/09031936.00010206. — View Citation

Dres M, Goligher EC, Heunks LMA, Brochard LJ. Critical illness-associated diaphragm weakness. Intensive Care Med. 2017 Oct;43(10):1441-1452. doi: 10.1007/s00134-017-4928-4. Epub 2017 Sep 15. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Mechanical ventilation weaning success	Weaning success: stable without mechanical ventilator support during more than 48 hours	48 hours
Primary	Mechanical ventilation weaning failure	Weaning failure: unstable without mechanical ventilator support within 48 hours	48 hours
Secondary	Mortality	Incidence of ICU mortality	ICU mortality after ultrasonography guided weaning