Electrical Activity of Diaphragm as a Means to Predict Extubation Success in Preterm Infants
| Status: | Completed |
|---|---|
| Conditions: | Hospital, Pulmonary |
| Therapuetic Areas: | Pulmonary / Respiratory Diseases, Other |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 4/21/2016 |
| Start Date: | August 2014 |
| End Date: | October 2015 |
A Prospective Study of Diaphragmatic Electrical Activity in Preterm Infants as a Means to Predict Extubation Success
Mechanical ventilation used to support the sick newborn infant is associated with many
complications including the development of chronic lung disease. Limiting prolonged invasive
ventilation remains an important strategy to decrease lung injury and prevent chronic lung
disease. Currently, there is no objective measure available to predict readiness for removal
of the endotracheal tube ("extubation") and discontinuing mechanical ventilation in this
fragile population.
The investigators propose to predict extubation success by evaluating the electrical
activity of the diaphragm (Edi), which provides important information about the "drive" to
breathing coming from the brain and the function of the diaphragm, two essential factors
determining extubation readiness and success.
complications including the development of chronic lung disease. Limiting prolonged invasive
ventilation remains an important strategy to decrease lung injury and prevent chronic lung
disease. Currently, there is no objective measure available to predict readiness for removal
of the endotracheal tube ("extubation") and discontinuing mechanical ventilation in this
fragile population.
The investigators propose to predict extubation success by evaluating the electrical
activity of the diaphragm (Edi), which provides important information about the "drive" to
breathing coming from the brain and the function of the diaphragm, two essential factors
determining extubation readiness and success.
In this observational study, very low birth weight preterm infants with RDS who require
mechanical ventilation in first 24 hour of life will be recruited. A size appropriate
nasogastric tube with multiple array of electrodes (Edi catheter) will be inserted in each
eligible infant. The average EdI (Edi_avg) will be measured during mechanical ventilation
just before extubation. All infants will be extubated to non-invasive positive pressure
ventilation (NIPPV or CPAP) delivered through nasal cannula
The specific aim is to determine whether there is a relationship between Edi_avg before
extubation and the extubation success in a sample of preterm infants with respiratory
distress syndrome (RDS). We hypothesize that Edi-avg of infants with successful extubation
will be significantly different from the infants who fail extubation
mechanical ventilation in first 24 hour of life will be recruited. A size appropriate
nasogastric tube with multiple array of electrodes (Edi catheter) will be inserted in each
eligible infant. The average EdI (Edi_avg) will be measured during mechanical ventilation
just before extubation. All infants will be extubated to non-invasive positive pressure
ventilation (NIPPV or CPAP) delivered through nasal cannula
The specific aim is to determine whether there is a relationship between Edi_avg before
extubation and the extubation success in a sample of preterm infants with respiratory
distress syndrome (RDS). We hypothesize that Edi-avg of infants with successful extubation
will be significantly different from the infants who fail extubation
Inclusion Criteria:
Preterm infants less than 35 week gestation, requiring intubation and mechanical
ventilation for respiratory distress in the first 24 hours of life
Exclusion Criteria:
Infants with a non-intact esophagus (e.g tracheal-esophageal fistula or atresia), a
non-functional diaphragm (e.g. phrenic nerve palsy), severe intracranial hemorrhage or
structural CNS abnormality, severe birth asphyxia and critically sick infant needing
paralysis or deep sedation.
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