Using ultrasound to predict successful extubation in ICU patients on mechanical ventilation
Predicting Extubation Outcomes in Mechanically Ventilated Patients Using PW-TDI Diaphragmatic Kinematics and Traditional Ventilation Parameters: A Prospective Study
This study is testing whether using ultrasound can help doctors better decide when it's safe to take ICU patients off mechanical ventilation after they've been on it for over 24 hours.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 200 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Affiliated Hospital of Jiangnan University Academic / other |
| Locations | 1 site (Wuxi, Jiangsu) |
| Trial ID | NCT06154811 on ClinicalTrials.gov |
What this trial studies
This observational study aims to improve the timing of extubation for mechanically ventilated patients in the ICU by utilizing pulse tissue Doppler and ultrasound techniques. Patients who have been intubated for over 24 hours will undergo a spontaneous breathing trial (SBT) followed by ultrasound assessments to evaluate their readiness for extubation. The study will analyze various parameters, including the Rapid Shallow Breathing Index (RSBI) and the APACHE II score, to enhance the prediction of extubation outcomes. The goal is to reduce the extubation failure rate, which currently ranges from 10% to 40%. The attending physician will make the final extubation decision based on clinical judgment, unaware of the ultrasound findings.
Who should consider this trial
Good fit: Ideal candidates are adults who have been intubated and mechanically ventilated for more than 24 hours and are ready for their first spontaneous breathing trial.
Not a fit: Patients with conditions such as diaphragmatic paralysis, significant pleural effusion, or those under 18 years old may not benefit from this study.
Why it matters
Potential benefit: If successful, this approach could significantly reduce extubation failure rates and improve outcomes for patients in the ICU.
How similar studies have performed: While the use of ultrasound in this context is promising, the specific combination of techniques being employed in this study is relatively novel and has not been extensively tested in prior studies.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patients were enrolled if participants had been intubated and mechanically ventilated for more than 24 hours and were ready for participants first SBT according to ICU weaning criteria. Exclusion Criteria: * paralytic drugs taken within 24 hours prior to the trial; * diagnosis of diaphragmatic paralysis or paradoxical movement of the hemidiaphragm detected by ultrasound or poor imaging quality; * Pregnancy; * Ascites; * age\<18years; * Post-thoracotomy; * Existence of pneumothorax; * presence of large pleural effusion, subcutaneous emphysema, flail chest or right-sided rib fractures; * presence of neuromuscular diseases.
Where this trial is running
Wuxi, Jiangsu
- Affiliated Hospital of Jiangnan University — Wuxi, Jiangsu, China (Recruiting)
Study contacts
- Study coordinator: Jun Liu, Master
- Email: 17751500920@sina.cn
- Phone: +8617751500920
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.