Acute respiratory distress (ARD) is one of the most frequent reasons for consultation and hospitalization in emergency medicine. The use of ultrasound methods as a diagnostic and clinical assessment tool in emergency medicine is increasingly important. As such, ultrasound is a simple, non-invasive means of assessing diaphragmatic function in the patient's bed. Several methods of ultrasound assessment of diaphragm function have been described. Among these different methods, the diaphragmatic excursion seems to have a better intra and interobserver reproducibility as well as a greater feasibility, in particular because of its speed of realization and its learning curve seeming faster in comparison with the measurement. of the thickening fraction. Measuring the diaphragmatic excursion could therefore ultimately represent a simple means of assessing respiratory function, both diagnostic and prognostic, in patients with acute respiratory distress in the emergency departments. The etiologies of acute respiratory distress in very elderly patients (i.e.\> 75 years) admitted to the emergency reception service are multiple. To our knowledge, there is no data available in the literature on the prevalence of diaphragmatic dysfunction and its short- and long-term course in this category of patients. The main objective of this study is therefore to assess the prevalence of diaphragmatic dysfunction and its evolutionary kinetics in patients over the age of 75 admitted for acute respiratory distress in the emergency medicine department.
Study Type
OBSERVATIONAL
Enrollment
100
Centre Hospitalier Universitaire de la Réunion
Saint-Denis, France
RECRUITINGPresence of diaphragmatic dysfunction
Ultrasound measurement of diaphragmatic excursion (ED)
Time frame: inclusion
Presence of diaphragmatic dysfunction
Ultrasound measurement of diaphragmatic excursion (ED)
Time frame: Day 1
Presence of diaphragmatic dysfunction
Ultrasound measurement of diaphragmatic excursion (ED)
Time frame: Day 3
Presence of diaphragmatic dysfunction
Ultrasound measurement of diaphragmatic excursion (ED)
Time frame: Day 7
Presence of diaphragmatic dysfunction
Ultrasound measurement of diaphragmatic excursion (ED)
Time frame: up to 7 days
Inter-observer reproductibility of the measurement of ED and EIT
Comparison of the measure in the between two operators
Time frame: Day 0
Predictive value of the presence of diaphragmatic dysfunction
Ultrasound measurement of diaphragmatic excursion (ED) on the use of ventilatory assistance
Time frame: 48 hours after the beginning of hospitalization
Predictive value of the presence of diaphragmatic dysfunction over the average length of hospital stay
length of hospitalization duration in Intensive care unit
Time frame: up to 7 days
Predictive value of the presence of a diaphragmatic dysfunction on mortality
Ultrasound measurement of diaphragmatic excursion (ED)
Time frame: up to 7 days
Predictive value of the presence of a diaphragmatic dysfunction on mortality
Ultrasound measurement of diaphragmatic excursion (ED)
Time frame: 6 months after the end of hospitalization
Kinetics of evolution of the diaphragmatic function
Ultrasound measurement of diaphragmatic excursion (ED)
Time frame: Day 1
Kinetics of evolution of the diaphragmatic function
Ultrasound measurement of diaphragmatic excursion (ED)
Time frame: Day 3
Evolution of the diaphragmatic function
Ultrasound measurement of diaphragmatic excursion (ED)
Time frame: Day 7
Evolution of the diaphragmatic function
Ultrasound measurement of diaphragmatic excursion (ED)
Time frame: Before 7 days
Correlation between risk factors for developing diaphragmatic dysfunction (DD) and ultrasound diagnosis of diaphragmatic dysfunction (DD)
Identification of the risk factors and Ultrasound measurement of diaphragmatic excursion (ED)
Time frame: up to 7 days
Possible correlation between the presence of a DD diagnosed by the ultrasound measurement of the ED and the duration of mechanical ventilation, the duration of hospitalization in ICU, respiratory complications rate and failures organs rate
qSOFA et APACHE II score
Time frame: up to 7 days
Correlation between the presence of DD diagnosed by ultrasound measurement of ED and the evolution of the functional status of the patient at the end of hospitalization compared to his status at the admission
scores ADL et AGGIR
Time frame: up to 7 days
Presence of diaphragmatic dysfunction in patients with COVID-19
Ultrasound measurement of diaphragmatic excursion (ED)
Time frame: up to 7 days
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