Ventilatory support during critical phase result in inactivity of respiratory muscles especially diaphragm muscle. These inactivity also result in change of contractile capability and quick muscular atrophy. The aim of the study is to visualize the evolution of diaphragm thickness by echography during Mechanical Ventilation for patients with septic shock or acute respiratory distress syndrome and to compare with the evolution for patients under non-invasive ventilation and those with spontaneous ventilation. Measurements will be performed at day 1, day 5 and day 10 (if patient still under a mode of ventilation or in the unit). The evolution of diaphragm thickness will also be compared to pectoralis muscle atrophy, which is not involved in ventilation, in order to assess respective effect of ventilatory inactivity and undernutrition linked to intensive care.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
97
An ultrasound of the right diaphragm will be performed on day 1, day 3, day 5 and day 10
An ultrasound of the pectoral muscle will be performed on day 1, day 3, day 5 and day 10
A neuromyopathy score will be assessed on the extubation day
An assessment of the respiratory performances will be done on the extubation day, including higher expiratory pressure, higher inspiratory pressure, and occlusion pressure
Change from day 1 diaphragm thickness at day 3 and day 5
Diaphragm thickness measured by ultrasound
Time frame: 1 day, 3 days and 5 days after introduction of Mechanical Ventilation
Diaphragm thickness measured by ultrasound
Time frame: 10 days after introduction of Mechanical Ventilation
Type of ventilatory support
Define which type of ventilatory support is used (mechanical ventilation, non-invasive ventilation, or spontaneous ventilation)
Time frame: 10 days after start of ventilatory support
Ventilatory mode
Ventilatory mode (controlled ventilation, pressure support ventilation)
Time frame: 10 days after start of ventilatory support
Pectoralis muscle thickness measured by ultrasound
To compare the importance of this atrophy to those of diaphragmatic muscle
Time frame: 10 days after start of ventilatory support
Diaphragmatic strength
Relation between diaphragmatic atrophy and decrease of diaphragmatic strength
Time frame: intraoperative
Early or late extubation failure rate (extubation performed before or after 48 hours)
Relation between diaphragmatic atrophy importance and premature (\<48h) or late extubation failure
Time frame: The last day of hospitalisation
MRC score (Medical Research Council)
Relation between diaphragmatic atrophy and decrease of diaphragmatic strength
Time frame: intraoperative
Length of ventilation in hours
Time frame: 10 days after start of ventilatory support
Drug administration
Presence of drug administration such as curare, corticoid or sedative. If yes : number of days with treatment
Time frame: 10 days after start of ventilatory support
Total positive end expiratory pressure
Time frame: 10 days after start of ventilatory support
External positive end expiratory pressure
Time frame: 10 days after start of ventilatory support
Respiratory rate
Time frame: 10 days after start of ventilatory support
Highest inspiratory pressure level
Time frame: 10 days after start of ventilatory support
Highest expiratory pressure level
Time frame: 10 days after start of ventilatory support
Volume of exhaled air
Time frame: 10 days after start of ventilatory support
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