Value of Diaphragmatic Motion Measurement at Ultrasonography to Predict Poor Prognosis in Emergency Department Patients With Acute Respiratory Failure

N/ACompletedNCT04119505

University Hospital, Montpellier350 enrolled

Overview

Acute respiratory failure is one of the most common diagnosis in patients admitted in the Emergency Department. Acute respiratory failure is associated with morbidity and mortality. Fifteen percent of patient will require ventilatory support and among them 40% will die. Measurement of diaphragmatic motion (excursion) at ultrasonography is a noninvasive measure, allowing to assess diaphragm dysfunction. It could be useful in predicting poor prognosis in ED patients with respiratory failure . In this study the investigators will compare the prognostic value of diaphragmatic excursion measurement at ultrasonography to that of the National Early Warning Score (NEWS) 2 in patients presenting with acute respiratory failure in the ED The Investigators made the hypothesis that measurement of diaphragmatic excursion in ED patients with acute respiratory failure could be of value in predicting the need for ventilatory support or mortality within 28 days from ED admission

Diaphragmatic dysfunction can be explored by measuring diaphragmatic excursion using ultrasonography in spontaneous ventilation patients. Patients in spontaneous ventilation will undergo both diaphragmatic excursion measurement at ultrasonography and assessment of the News2 score as part of standard care.

Study Type

OBSERVATIONAL

Enrollment

350

Conditions

Dyspnea Acute Respiratory Failure

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion criteria: * Age equal or over 18 y.o * Signs of acute respiratory failure defined by RR equal or over 25 br/min and/or signs of increased work of breathing * Patients on spontaneous breathing Exclusion criteria: * Medical history of diaphragmatic dysfunction including stroke or diaphragmatic paralysis * Patients on ventilatory support at ED admission or prior to inclusion * Patients treated with curare * Trauma patients

Outcomes

Primary Outcomes

Number of patients with adverse events

Adverse events are defined as a composite of mortality and/or cardiac arrest and/or need for ventilatory support (including invasive and/or noninvasive ventilation and/or high flow nasal cannula therapy) within 28 days from ED admission.

Time frame: 28 days

Secondary Outcomes

Delay to initiation of ventilatory support

Ventilatory support is defined as invasive mechanical ventilation or non invasive ventilation or high-flow nasal cannula

Time frame: at day 28

Number of patients with adverse events at ED discharge

Time frame: through ED stay (up to a day)

Number of patients with adverse events at hospital discharge

Time frame: through hospital stay (up to a week)