Comparison of ultrasound assessment for diaphragmatic workload during spontaneous breathing trial between automatic tube compensation and pressure support ventilation: Study protocol

Authors

  • Nutarpa Kulkanokwan Division of Critical Care Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Sunthiti Morakul Department of Anesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Chawika Pisitsak Department of Anesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Pongdhep Theerawit Division of Critical Care Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

DOI:

https://doi.org/10.54205/ccc.v30.255057

Keywords:

Automatic tube compensation, Pressure support ventilation, Ultrasound diaphragm, Diaphragm thickness fraction, TDI-derived maximal relaxation rate

Abstract

Background: The process of weaning from mechanical ventilation is crucial. Less demanding spontaneous breathing trials (SBT) can be done by either automatic tube compensation (ATC) or pressure support ventilation (PSV) to decrease inspiratory effort by endotracheal tube resistance compensation. This study aimed to assess the patient’s effort, by diaphragm ultrasonography with ATC compared to PSV during SBT.

Methods: Patients who have been on mechanical ventilation for more than 48 hours and meet the weaning requirements are given 30 minutes for ATC and 30 minutes for PSV in this randomized control experiment. The diaphragm workload difference, as assessed by diaphragm thickness fraction, was the primary outcome. The sensitivity and specificity of ultrasound-measured diaphragmatic muscle activity measures in predicting ventilator weaning and effective extubation were secondary outcomes.

Hypothesis: Intubated patients should be (1) weaning with lower effort SBT mode (2) predicted weaning success with more accurately parameters

Ethics and dissemination: Ramathibodi Human Research Ethics Committee has approved the trial. The findings plan to summitted in peer-reviewed publications and conferences in critical care medicine or anesthesiology.

Trial registration number: TCTR20210317004

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Published

2022-03-30

How to Cite

1.
Kulkanokwan N, Morakul S, Pisitsak C, Theerawit P. Comparison of ultrasound assessment for diaphragmatic workload during spontaneous breathing trial between automatic tube compensation and pressure support ventilation: Study protocol. Clin Crit Care [Internet]. 2022 Mar. 30 [cited 2024 Jun. 20];30:2022:e0004. Available from: https://he02.tci-thaijo.org/index.php/ccc/article/view/255057

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Section

Research Protocol