Therapeutically Alternatives In Ventilator-Induced Diaphragm Dysfunction Critically Ill Patients

South Valley University

Status: Not yet enrolling

Conditions: Ventilator-Induced Diaphragmatic Dysfunction

Treatments: Device: Practice flow trigger sensitivity adjustment on mechanical ventilation for 1 week twice daily in addition to their plan of treatment.

Study type: Interventional

Funder types: Other

Identifiers

NCT06515600

Diaphragm Dysfunction

Details and patient eligibility

About

The study is a prospective experimental study on adult patients admitted to the Critical Care Department in Qasr Al-Ainy. This study is conducted prospectively to assess the efficiency of trigger sensitivity adjustment on patients with ventilator-induced diaphragmatic dysfunction (VIDD).

Full description

The study is a prospective experimental study on adult patients admitted to the Critical Care Department in Qasr Al-Ainy. This study is conducted prospectively to assess the efficiency of trigger sensitivity adjustment on patients with ventilator-induced diaphragmatic dysfunction (VIDD).1. Flow Trigger: This type of trigger responds to the gas flow during inspiration. A flow trigger measures the rate of change of flow as the patient begins to inhale. When the flow reaches a certain threshold, the ventilator is triggered to deliver a breath.

1. Laboratory investigations: Arterial blood gases (ABG):- (PH, PCO2, HCO3, and PO2) after the session.
2. Ventilator Parameters:( a) Minute Ventilation, b) Tidal Volume, c) Rapid Shallow breathing index, d) Negative Inspiratory Force (NIF) will be measured pre and post-treatment

Enrollment: 30 estimated patients

Sex: All

Ages: 20 to 90 years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Age (years)

Weight (kg)

Height (cm)

BMI (kg/m²)

Inclusion Criteria:

• Patients who had undergone MV for 48 hours or more in a controlled mode.
• Patients could not generate maximum inspiratory pressure of more than 15 mbar
• Patients had diaphragmatic excursion less than 3 cm. (normal level from 3 to 5 cm.)(It can increase in a condition person to 7-8 cm).
• Patients had a diaphragmatic thickness fraction of less than 30%

Exclusion Criteria:

• Patients with comorbidities interfering and compromising weaning like cardiac arrhythmia, pericardial effusion, congestive heart failure, or unstable acute coronary syndrome.
• Patients who had inadequate training performance of the inspiratory muscle such as those having myopathy or neuropathy.
• Patients hemodynamically unstable.
• Patients who had a major neurological deficit.
• Sedated Patients.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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30 participants in 2 patient groups

Study group

Experimental group

Description:

Group (A) (study group) will include 30 patients who practiced flow trigger sensitivity adjustment on mechanical ventilation for 1 week twice daily in addition to their plan of treatment.

Treatment:

Device: Practice flow trigger sensitivity adjustment on mechanical ventilation for 1 week twice daily in addition to their plan of treatment.

Controlled group

Active Comparator group

Description:

Group (B) (controlled group) will include 30 patients who received their routine plan of weaning of mechanical ventilator (controlled mode then spontaneous mode and finally spontaneous breathing trial).

Treatment:

Device: Practice flow trigger sensitivity adjustment on mechanical ventilation for 1 week twice daily in addition to their plan of treatment.