Therapeutically Alternatives In Ventilator-Induced Diaphragm Dysfunction Critically Ill Patients

N/ANot Yet RecruitingNCT06515600

South Valley University30 enrolled

Overview

The study is a prospective experimental study on adult patients admitted to the Critical Care Department in Qasr Al-Ainy. This study is conducted prospectively to assess the efficiency of trigger sensitivity adjustment on patients with ventilator-induced diaphragmatic dysfunction (VIDD).1. Flow Trigger: This type of trigger responds to the gas flow during inspiration. A flow trigger measures the rate of change of flow as the patient begins to inhale. When the flow reaches a certain threshold, the ventilator is triggered to deliver a breath. 1. Laboratory investigations: Arterial blood gases (ABG):- (PH, PCO2, HCO3, and PO2) after the session. 2. Ventilator Parameters:( a) Minute Ventilation, b) Tidal Volume, c) Rapid Shallow breathing index, d) Negative Inspiratory Force (NIF) will be measured pre and post-treatment

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Ventilator-Induced Diaphragmatic Dysfunction

Interventions

Practice flow trigger sensitivity adjustment on mechanical ventilation for 1 week twice daily in addition to their plan of treatment.DEVICE

All patients were investigated by routine investigation (vital signs, arterial blood gas, ventilator mode, and the parameters). Two sessions were implemented per day for the study group for one week. The Trigger sensitivity adjustment trial begins with applying a load of 30% of the first recorded Negative Inspiratory Force (NIF). 1. st Day 1st session, 30% 5 min. 2. nd session, 30% 10 min. 2nd Day 1st session, 30% 15 min 2nd session, 30% 20 min. 3rd Day 1st session, 30% 25 min. 2nd session, 30% 30 min. 4th Day 1st session, 40% 5 min. 2nd session, 40% 10 min. 5th Day 1st session 40% 15 min 2nd session 40% 20 min. 6th Day 1st session 40% 25 min. 2nd session 40% 30 min. 7th Day 1st session 50% 5 min. 2nd session 50% 10 min.

Eligibility

Sex: ALLMin age: 20 YearsMax age: 90 YearsHealthy volunteers:

Medical Language ↔ Plain English

Age (years) Weight (kg) Height (cm) BMI (kg/m²) Inclusion Criteria: * Patients who had undergone MV for 48 hours or more in a controlled mode. * Patients could not generate maximum inspiratory pressure of more than 15 mbar * Patients had diaphragmatic excursion less than 3 cm. (normal level from 3 to 5 cm.)(It can increase in a condition person to 7-8 cm). * Patients had a diaphragmatic thickness fraction of less than 30% Exclusion Criteria: * Patients with comorbidities interfering and compromising weaning like cardiac arrhythmia, pericardial effusion, congestive heart failure, or unstable acute coronary syndrome. * Patients who had inadequate training performance of the inspiratory muscle such as those having myopathy or neuropathy. * Patients hemodynamically unstable. * Patients who had a major neurological deficit. * Sedated Patients.

Outcomes

Primary Outcomes

Vital signs

Heart Rate (HR) b/min

Time frame: one week

Respiratory rate RR/min

Time frame: one week

Blood Pressure mmHg

Time frame: one week

Arterial blood gases (ABG):-

Time frame: one week

PCO2 mmHg

Time frame: one week

HCO3 mEQ/Liter

Time frame: one week

PSAO2 mmHg

Time frame: one week

Secondary Outcomes

Ventilator parameters

Minute Ventilation L/min

Time frame: one week

Tidal Volume L/breath

Time frame: one week

Data from ClinicalTrials.gov

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