Ultrafast Ultrasonographic Oro-laryngeal Measurement in Critically Ill Patients During Weaning From Mechanical Ventilation

Groupe Hospitalier du Havre150 enrolled

Overview

In ICU, ventilatory weaning failure is common, accounting for up to 25% of extubations. These failures are largely due to swallowing disorders and laryngeal edema. Edema prevalence in ICU varies between 4 and 37%. Post-extubation stridor is a clinical sign of upper airway obstruction and may require urgent reintubation, which is associated with increased patient length of stay, morbidity and mortality. Identifying patients at risk is critical, and the need for reliable tools to predict the occurence of laryngeal edema is still relevant.

Study Type

OBSERVATIONAL

Enrollment

150

Conditions

Laryngeal Edema

Interventions

Ultrafast ultrasonographyOTHER

Ultrasonography of the neck, patient in supine position, neck hyper-extended. Three different scanning planes containing several landmarks. Carried out in the 12h prior extubation.

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * Adults, * Intubated and ventilated for more than 24h, * Filing mechanical ventilation weaning criteria. Exclusion Criteria: * Pregnant of breast-feeding woman, * Under guardianship patient, * History of laryngeal tumor, stroke, paralysis of recurrent nerve, swallowing disorders, * History of surgical laryngeal intervention or radiotherapy, * Unplanned extubation, * Opposition to take part in the study.

Outcomes

Primary Outcomes

Correlation between laryngeal ultrafast ultrasonography and occurence of laryngeal edema

A laryngeal edema is defined as a post-extubation stridor. Performance of ultrafast ultrasonography for laryngeal edema prediction in intensive care patients will be assessed with specificity, sensitivity, positive predictive value and negative predictive value.

Time frame: Within the 24 hours following extubation

Secondary Outcomes

Correlation between laryngeal ultrafast ultrasonography and occurence of swallowing disorders

Performance of ultrafast ultrasonography for swallowing disorsders prediction in intensive care patients will be assessed with specificity, sensitivity, positive predictive value and negative predictive value.