Diaphragm Training Ultrasound
Summary
Common neurological indications of intubation and initiation of mechanical ventilation (MV) include ischemic and hemorrhagic stroke, neurotrauma, and intracranial hemorrhage. Mechanical ventilation is frequently applied to protect the airway from the risk of aspiration and to prevent both hypoxemia and hypercapnia, which are two major systemic factors of secondary brain insult (Faez et al., 2016, 2016; Asehnoune, Roquilly and Cinotti, 2018).
Mechanical ventilation after endotracheal intubation predisposes these patients to an increased incidence of pulmonary complications such as ventilator-associated pneumonia (VAP), increased risk of deep vein thrombosis, bedsores, increased hospital stay, and poor clinical outcome ( El-naggar, Raafat, and Mohamed, 2018; G et al., 2019).
The weaning process from MV involves the reduction of ventilator parameters and Extubation (Zein et al., 2016). Daily, careful evaluation of clinical and neurological conditions and completion of spontaneous breathing trial (SBT) should be considered in order to recognize and facilitate the process of withdrawal of the MV(Faez et al., 2016; Patricia Kritek, 2019).
The diaphragm which is the principal respiratory muscle provides nearly 75% of the resting pulmonary ventilation(Soliman et al., 2019). However, In ICU patients, the diaphragm is vulnerable to damage from hypotension, hypoxia, and sepsis(Bruni et al., 2017; Li et al., 2018; Qian et al., 2018). Diaphragmatic dysfunction and atrophy is the main precipitating factor for difficult and successful weaning (Dres and Demoule, 2018).
Study Design
Conditions
DIAPHRAGM -Ultrasound -Weaning -Mechanical Ventilation
Intervention
DIAPHRAGMATIC exercising
Status
Not yet recruiting
Source
Mansoura University
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT04186325
- ClinicalTrials.gov processed this data on December 09, 2019
Published on BioPortfolio: 2019-12-10T01:20:58-0500
Clinical Trials
Diaphragmatic Ultrasound as a Guide Tool During Weaning From Mechanical Ventilation
To assess value of adding ultrasound derived variables to the usual parameters on success rate of weaning from mechanical ventilation in critically ill patients and to validate sensitivity...
The Rapid Shallow Breathing Index (RSBI) is the ratio between respiratory rate (RR) and tidal volume (VT). It is routinely used to predict mechanical ventilation weaning outcome in ICU pat...
Diaphragmatic Tissue Doppler During Weaning From Mechanical Ventilation
Weaning from mechanical ventilation is a critical issue and the diaphragmatic disfunction has been demonstrated to play an important role in extubation failure. the aim of present investig...
Predicting successful discontinuation from mechanical ventilation has been a focus of interest to all critical care physicians . Various weaning indices have been investigated to optimize ...
Justification: The diaphragm is the main inspiratory muscle. Its dysfunction therefore compromises ventilation, which is necessary for gas exchange. Diaphragmatic dysfunction is frequently...
PubMed Articles
Oxidants Regulated Diaphragm Proteolysis during Mechanical Ventilation in Rats.
Diaphragm dysfunction and atrophy develop during controlled mechanical ventilation. Although oxidative stress injures muscle during controlled mechanical ventilation, it is unclear whether it causes a...
Distinct neural-mechanical efficiency of costal and crural diaphragm during hypercapnia.
Classic physiology suggests that the two distinct diaphragm segments, costal and crural, are functionally different. It is not known if the two diaphragm muscles share a common neural mechanical activ...
Mechanical ventilation is one of the most commonly used treatments in neonatology. Prolonged mechanical ventilation is associated with deleterious outcomes. To reduce the ventilation duration, weaning...
Diaphragmatic paralysis in young children: A literature review.
Diaphragmatic paralysis (DP) is a rare cause of respiratory distress in young children. In the first years of life, the main cause is phrenic nerve injury after cardiothoracic surgery or obstetrical t...
Both pressure-support and pressure-controlled ventilation may be used in patients with acute respiratory distress syndromeThe importance of static and dynamic transpulmonary driving pressure during me...
Medical and Biotech [MESH] Definitions
Ventilator Weaning
Techniques for effecting the transition of the respiratory-failure patient from mechanical ventilation to spontaneous ventilation, while meeting the criteria that tidal volume be above a given threshold (greater than 5 ml/kg), respiratory frequency be below a given count (less than 30 breaths/min), and oxygen partial pressure be above a given threshold (PaO2 greater than 50mm Hg). Weaning studies focus on finding methods to monitor and predict the outcome of mechanical ventilator weaning as well as finding ventilatory support techniques which will facilitate successful weaning. Present methods include intermittent mandatory ventilation, intermittent positive pressure ventilation, and mandatory minute volume ventilation.
Diaphragmatic Eventration
A congenital abnormality characterized by the elevation of the DIAPHRAGM dome. It is the result of a thinned diaphragmatic muscle and injured PHRENIC NERVE, allowing the intra-abdominal viscera to push the diaphragm upward against the LUNG.
Ventilators, Mechanical
Mechanical devices used to produce or assist pulmonary ventilation.
Interactive Ventilatory Support
Mechanical ventilation delivered to match the patient's efforts in breathing as detected by the interactive ventilation device.
Bronchopulmonary Dysplasia
A chronic lung disease developed after OXYGEN INHALATION THERAPY or mechanical ventilation (VENTILATION, MECHANICAL) usually occurring in certain premature infants (INFANT, PREMATURE) or newborn infants with respiratory distress syndrome (RESPIRATORY DISTRESS SYNDROME, NEWBORN). Histologically, it is characterized by the unusual abnormalities of the bronchioles, such as METAPLASIA, decrease in alveolar number, and formation of CYSTS.
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