Diaphragm Response in Elderly for Acute Monitoring
DREAM
Using Diaphragmatic Ultrasound to Predict Acute Respiratory Distress (ARD) in Patients Aged 75 and Over Admitted to the Emergency Department for Acute Dyspnea : Prospective Multicenter Study.
2 other identifiers
observational
145
1 country
9
Brief Summary
Acute dyspnea is a common cause of emergency department admissions among elderly patients. Acute respiratory failure is often multifactorial and requires rapid and reliable evaluation. Currently, management relies on clinical, biological, and radiological assessments, but diaphragmatic ultrasound could provide an additional tool for real-time respiratory function evaluation. This study aims to integrate this non-invasive technology into the initial assessment of patients to improve care pathways. Hypothesis : Diaphragmatic ultrasound enables reliable assessment of respiratory function and can predict the need for mechanical ventilation.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P50-P75 for all trials
Started Jun 2026
9 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
July 3, 2025
CompletedFirst Posted
Study publicly available on registry
August 20, 2025
CompletedStudy Start
First participant enrolled
June 1, 2026
ExpectedPrimary Completion
Last participant's last visit for primary outcome
June 1, 2028
Study Completion
Last participant's last visit for all outcomes
June 1, 2028
May 6, 2026
May 1, 2026
2 years
July 3, 2025
May 5, 2026
Conditions
Outcome Measures
Primary Outcomes (1)
Occurrence of a severe acute respiratory event within 7 days of admission
* Placement on invasive mechanical ventilation (intubation) or non invasive ventilation (NIV, high-flow oxygen therapy), * Respiratory death, confirmed by an independent adjudication committee blinded to the ultrasound results. Explanatory variable: The presence of impaired diaphragmatic function at admission will be defined by: * a Tdi (tele-inspiratory thickness) \<10%, and/or * a diaphragmatic excursion \<10 mm.
WITHIN 7 DAYS OF ADMISSION
Secondary Outcomes (2)
Measurement of diaphragmatic excursion AND Etiology of acute dyspnea
within 7 days
To evaluate the contribution of diaphragmatic ultrasound to the NEWS2 score performed on admission in predicting the occurrence of acute respiratory distress within 7 days.
within 7 days
Eligibility Criteria
Patients Aged 75 and Over Admitted to the Emergency Department for Acute Dyspnea
You may qualify if:
- Patients aged ≥ 75 years
- Emergency admission for acute dyspnea
- Requiring an emergency ultrsoung.
You may not qualify if:
- Acute respiratory distress requiring immediate invasive or non-invasive ventilation
- Respiratory rate ≥ 25 breaths/min, and/or SpO2 ≤ 90% on room air, and/or PaO2 ≤ 60 mmHg
- Known diaphragmatic paralysis
- Patients with degenerative neuromuscular disease
- State of shock: systolic blood pressure \< 90 mmHg and/or mean arterial pressure \< 65 mmHg and/or presence of skin mottling and/or CTR \> 3s
- Lactate levels \> 2 mmol/L
- Hypercapnic respiratory acidosis (pH \< 7.38 and PaCO2 \> 45 mmHg)
- Dyspnea due to metabolic acidosis (e.g., diabetic ketoacidosis, renal failure)
- Dyspnea of traumatic origin
- Refusal to participate or inability to provide informed consent
- Patients deprived of liberty
- Patients under guardianship or curatorship
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (9)
Centre Hospitalier Victor Dupouy
Argenteuil, 95100, France
Centre Hospitalier de Béthune
Béthune, 62408, France
Centre Hospitalier de Douai
Douai, 59507, France
Centre Hospitalier Emile Roux
Le Puy-en-Velay, 43000, France
Centre Hospitalier Sud Ile-de-France
Melun, 77000, France
Centre Hospitalier de Roubaix
Roubaix, 59100, France
Centre Hospitalier de Saint-Lô
Saint-Lô, 50000, France
Centre Hospitalier de Tourcoing
Tourcoing, 59208, France
Centre Hospitalier de Valenciennes
Valenciennes, 59300, France
Study Officials
- STUDY DIRECTOR
Alain-Eric DUBART
Centre Hospitalier de Béthune-Beuvry
Central Study Contacts
Study Design
- Study Type
- observational
- Observational Model
- COHORT
- Time Perspective
- PROSPECTIVE
- Sponsor Type
- NETWORK
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
July 3, 2025
First Posted
August 20, 2025
Study Start (Estimated)
June 1, 2026
Primary Completion (Estimated)
June 1, 2028
Study Completion (Estimated)
June 1, 2028
Last Updated
May 6, 2026
Record last verified: 2026-05