Evaluation of Left Ventricular Function to Predict Weaning Success in the Intensive Care Unit

NCT07075926 | Recruiting

• 1 other identifier: Weaning-Left Heart
• Study Type: observational
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this prospective observational study is to evaluate whether left ventricular function parameters assessed via transthoracic echocardiography (TTE) can predict weaning success from mechanical ventilation in adult intensive care unit (ICU) patients. The main questions it aims to answer are: Can the Left Ventricular Outflow Tract Velocity Time Integral (LVOT VTI) predict successful extubation? What is the prognostic value of other echocardiographic measures such as Mitral Annular Plane Systolic Excursion (MAPSE), E/e' ratio, E/A ratio, Mitral Deceleration Time (MDT), and Myocardial Performance Index (Tei index) in forecasting weaning outcomes? Participants will: Be adults receiving mechanical ventilation and scheduled for weaning Undergo transthoracic echocardiography (TTE) within 2 hours after meeting weaning criteria Have the following parameters measured: LVOT VTI, MAPSE, E/e', E/A, MDT, and Tei index Be monitored for 24 hours post-extubation to determine if they remain off ventilatory support, including reintubation, non-invasive ventilation, or high-flow oxygen therapy This study aims to provide a comprehensive understanding of how systolic, diastolic, and global cardiac functions influence extubation success, potentially improving ICU decision-making and reducing complications, length of stay, and healthcare costs.

Conditions

Weaning Failure of Mechanical Ventilation

Outcome Measures

Primary Outcomes (1)

• Predictive Value of LVOT VTI in Determining Weaning Success

  To evaluate whether the Left Ventricular Outflow Tract Velocity Time Integral (LVOT VTI) measured by transthoracic echocardiography (TTE) within 2 hours after fulfilling weaning criteria can predict successful weaning from mechanical ventilation. Successful weaning is defined as maintaining spontaneous breathing for at least 24 hours without requiring reintubation, non-invasive ventilation, or high-flow nasal oxygen therapy.

  Within 24 hours after extubation

Secondary Outcomes (1)

• Predictive Value of Additional Left Ventricular Function Parameters in Weaning Success

  Within 24 hours after extubation

Study Arms (1)

Weaning Candidates

This group includes adult ICU patients who are receiving mechanical ventilation and have met standardized weaning criteria. All patients in this cohort will undergo transthoracic echocardiographic (TTE) assessment before extubation, without any experimental intervention applied.

Diagnostic Test: Echocardiographic Assessment

Interventions

Echocardiographic Assessment DIAGNOSTIC_TEST

All participants will receive a standardized transthoracic echocardiographic (TTE) examination within 2 hours after meeting weaning criteria. The following cardiac function parameters will be recorded: LVOT Velocity Time Integral (VTI) Mitral Annular Plane Systolic Excursion (MAPSE) E/e' ratio E/A ratio Mitral Deceleration Time (MDT) Myocardial Performance Index (Tei index) The echocardiographic data will be used to investigate the association between left ventricular function and weaning success.

Weaning Candidates

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population will consist of adult patients admitted to the intensive care unit (ICU) who are receiving invasive mechanical ventilation and are scheduled for extubation after fulfilling standard weaning criteria. All participants will be hemodynamically stable at the time of echocardiographic assessment. Patients with significant structural heart disease, inadequate echocardiographic imaging windows, or ongoing extracorporeal support will be excluded. The population represents a typical critically ill cohort undergoing weaning from mechanical ventilation.

You may qualify if:

• Currently receiving mechanical ventilation in the ICU
• Planned extubation after meeting standard weaning criteria
• Hemodynamically stable at the time of echocardiographic evaluation
• Written informed consent obtained from the patient or legally authorized representative

You may not qualify if:

• Surgery within the previous 24 hours
• Presence of significant valvular heart disease or known cardiomyopathy
• Inadequate acoustic window for transthoracic echocardiography
• Ongoing use of extracorporeal support (e.g., ECMO)
• Patients with Do-Not-Resuscitate (DNR) orders or expected to die within 24 hours
• Re-intubation planned prophylactically regardless of clinical status
• Pregnant patients

Sponsors & Collaborators

• Kanuni Sultan Suleyman Training and Research Hospital: lead

Study Sites (1)

Health Science University İstanbul Kanuni Sultan Süleyman Education and Training Hospital

Istanbul, Istanbul, 34303, Turkey (Türkiye)

RECRUITING

Central Study Contacts

Engin ihsan Turan, principal investigator

CONTACT

+905382431114; enginihsan@hotmail.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Day
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: principal investigator

Study Record Dates

• First Submitted: July 10, 2025
• First Posted: July 20, 2025
• Study Start: July 31, 2025
• Primary Completion (Estimated): July 15, 2026
• Study Completion (Estimated): July 16, 2026
• Last Updated: September 9, 2025

Record last verified: 2025-07

Locations

TU (1)