The MYOTRAUMA Study
Diaphragm Injury and Dysfunction During Mechanical Ventilation
Study Investigators
Dr. Ewan Goligher (ext. 6810, ewan.goligher@uhn.ca)
Dr. Niall Ferguson
Study Contact
Jenna Wong (ext. 7613, jenna.wong@uhn.ca)
Samira Fard (samira.fard@uhn.ca)
Study Summary
During mechanical ventilation, the diaphragm might be significantly injured by disuse atrophy, patient-ventilator dyssynchrony, or by excess loading (particularly post-inspiratory loading).
The burden of exposure to mechanisms of diaphragm injury in the clinical setting has not been definitively characterized.
The impact of these injury mechanisms on diaphragm function in the clinical setting is uncertain.
Study Population
Patients intubated for ARDS, sepsis, pneumonia, or severe acute brain injury (pre-intubation GCS < 8) [rationale: to enroll patients requiring at least 1 week of MV].
Patients are eligible for up to 36 hours following intubation.
Study Objectives
To characterize the burden of exposure to the putative mechanisms of VIDD in the clinical setting.
To assess the effect of those mechanisms on diaphragm function in the clinical setting.
Study Interventions
Once enrolled, an esophageal catheter fitted with gastric and esophageal balloons along with EMG electrodes is placed to monitor and record diaphragm activity on an hourly basis for 24 hours per day until extubation or the end of study day 7.
Diaphragm ultrasound is performed daily for up to 14 days (or until extubation or death if earlier).
