Incidence and Impact of ICU-acquired Diaphragm Weakness
Assistance Publique - Hôpitaux de Paris
194 participants
Jul 29, 2024
OBSERVATIONAL
Conditions
Summary
ICU survivors are at an increased risk of hospital and ICU readmission. Among the complications of ICU stay, diaphragmatic dysfunction is common, with a prevalence of 60 to 80%, and is associated with increased mortality and prolonged hospital stays. Furthermore, several studies have reported that the observation of impaired respiratory muscle function upon ICU discharge is associated with a poor long-term prognosis. However, the incidence and prognostic impact of persistent diaphragmatic dysfunction at ICU discharge have never been evaluated. The measurement of dyspnea, a composite evaluation of respiratory muscle function, has not been assessed for predicting prognosis upon ICU discharge. The hypothesis of the project is that the presence of ICU-acquired diaphragmatic dysfunction at ICU discharge is associated with a poorer prognosis within 90 days.
Eligibility
Inclusion Criteria4
- Age ≥ 18 years
- Invasive or non-invasive respiratory support (ventilation, high-flow oxygen therapy, whatever the reason) for at least 48 hours.
- Weaning from respiratory support (invasive or not) within the last 24 hours.
- Patient (or trusted person/relative) informed and not opposed to the study.
Exclusion Criteria4
- Known pre-existing diaphragmatic dysfunction (phrenic lesion, neuromuscular disease, etc.)
- Patients with tracheostomy
- Non-communicating patients
- Patients deprived of liberty by court or administrative order, or under legal protection (guardianship, curators).
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Interventions
At the inclusion visit, anamnestic data available in the medical record and clinical data (vitals, chest X-ray) will be collected. At the same time, a diaphragmatic ultrasound will be performed in the half-seated position to measure diaphragmatic excursion and the thickening fraction of the right hemi-diaphragm at rest. A follow-up visit will be made on the day of discharge from intensive care, during which diaphragmatic ultrasound will be performed At D90 (+/- 15 days), the following information will be collected by consulting the electronic medical record, or by telephone if the information is not available in the record: date of discharge from hospital, date of death, date and reason for readmission to hospital or intensive care, possible introduction of long-term non-invasive ventilation, new respiratory complication after discharge from intensive care (pneumonia, atelectasis).
Locations(1)
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NCT06420999