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ID
Source
Brief title
Health condition
patient-ventilator dyssynchrony, prolonged mechanical ventilation, muscle weakness, weaning
Sponsors and support
Intervention
Outcome measures
Primary outcome
-Correlation of transcutaneous sEMG of the diaphragm with airway pressure and flow to detect -patient – ventilator dyssynchrony
-Correlation of transcutaneous sEMG of the diaphragm with EAdi signal of NAVA catheter.
-Changes in sEMG signals during increased physical activity
-Correlation of sEMG fatigue parameters with clinical parameters of fatigue during weaning from mechanical ventilation
Secondary outcome
Feasibility of sEMG on the ICU
Background summary
Patients on the intensive care unit often need mechanical ventilation. Mechanical ventilation is harmful for the diaphragm. This leads to diaphragmatic dysfunction and weakness. One of the causes is patient-ventilator dyssynchrony (PVD). PVD is a frequent problem on the ICU, but detection demands expertise and time. PVD can lead to prolonged mechanical ventilation and ICU stay.
In patients with diaphragmatic weakness, weaning from mechanical ventilation has to be done carefully. This time-consuming process leads to a prolonged stay on the ICU, which is associated with an increased risk of infections, mortality and increased costs.
Optimized monitoring of diaphragm function might be able to detect patient-ventilator dyssynchrony and might accelerate the weaning process and diminish the length of mechanical ventilation and ICU stay.
The electrical activity of the diaphragm (EAdi) can be detected by three electromyography (EMG) methods: transcutaneous EMG, intramuscular EMG and transesophageal EMG. Transcutaneous electromyography, also called surface electromyography (sEMG), is the least invasive method. In this pilot study we aim to investigate the additional value of sEMG signals of respiratory muscles during ICU admission in adults.
Study objective
-Surface electromyography (sEMG) of the diaphragm can detect patient-ventilator dyssynchrony
-sEMG of the diaphragm correlates with the Eadi signals of a transesophageal EMG catheter
-sEMG changes with increased physical activity on the ICU
-sEMG fatigue parameters correlate with clinical parameters of fatigue during weaning from mechanical ventilation
Study design
Recordings of 15 minutes to maximum 4 hours (depending on research question)
Intervention
Surface electromyography of the diaphragm and intercostal muscles
Inclusion criteria
-Consecutive patients admitted to the ICU of the Academic Medical Center Amsterdam
-Age ≥ 18 years
-Expected duration of mechanical ventilation for ≥ 48 hours
-Informed consent
Exclusion criteria
-(Suspected) neuromuscular disease (other than ICU-AW) or cervical spinal cord injury
-Known phrenic nerve injury
-Contraindication for electrode placement (e.g. severe skin infection at electrode site)
Design
Recruitment
Followed up by the following (possibly more current) registration
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| NTR-new | NL4615 |
| NTR-old | NTR4766 |
| CCMO | NL50006.018.14 |
| OMON | NL-OMON40797 |