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Not yet recruitingNCT07788170Updated Aug 26, 2026

Nutritional Risk and Diaphragmatic Thickness in Mechanically Ventilated COPD Patients

An observational study in Chronic Obstructive Pulmonary Disease (COPD), Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Malnutrition, sponsored by Assiut University. Not yet recruiting. Open to participants aged 60 Years and older. Per ClinicalTrials.gov, last updated 2026-08-26.

Sponsored by Assiut University · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
120
Ages
60 Years and older
Sex
All
01

Study summary

Malnutrition and muscle wasting are frequent complications in patients with chronic obstructive pulmonary disease (COPD) experiencing acute exacerbations. In critically ill patients who require invasive mechanical ventilation, nutritional depletion and ventilator-induced diaphragmatic dysfunction can complicate recovery and prolong intensive care unit (ICU) stays.

The purpose of this prospective observational cohort study is to evaluate nutritional status and diaphragmatic structure in elderly patients (aged 60 years and older) with COPD who require invasive mechanical ventilation for at least 48 hours.

Participants will undergo bedside assessments, including:

  • Calculation of clinical risk scores within the first 24 hours of ICU admission: modified Nutrition Risk in the Critically Ill (mNUTRIC), Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health Evaluation II (APACHE II).
  • Anthropometric measurements: mid-upper arm circumference (MUAC) and calf circumference (CC) measured at baseline, day 7, and the day of weaning.
  • Diaphragmatic ultrasonography: point-of-care ultrasound to measure diaphragm thickness at end-expiration and end-inspiration at baseline, day 7, and during weaning trials.

The main goal is to evaluate the relationship between nutritional risk (assessed by the mNUTRIC score) and diaphragmatic thickness, and to determine how these parameters correlate with clinical outcomes such as weaning success, total duration of mechanical ventilation, ICU length of stay, and ICU mortality.

Read the detailed description

Malnutrition is a prevalent comorbidity in chronic obstructive pulmonary disease (COPD) associated with lower exercise tolerance, decreased pulmonary function, and increased mortality. In the intensive care unit (ICU), acute exacerbations requiring invasive mechanical ventilation frequently lead to accelerated muscle wasting and ventilator-induced diaphragmatic dysfunction. Combining bedside clinical risk scoring, peripheral anthropometry, and diaphragmatic ultrasonography provides a comprehensive approach to evaluating nutritional and functional reserve.

Eligible patients aged 60 years or older admitted with acute exacerbations of COPD requiring invasive mechanical ventilation for at least 48 hours will be prospectively enrolled.

Clinical and Severity Scoring (Day 1): Within the first 24 hours of admission and ventilation initiation, baseline demographic data, arterial blood gases, and severity scores will be recorded. Scores include the modified Nutrition Risk in the Critically Ill (mNUTRIC; range 0-9, where ≥ 5 defines high nutritional risk), Sequential Organ Failure Assessment (SOFA; range 0-24), and Acute Physiology and Chronic Health Evaluation II (APACHE II; range 0-71).

Anthropometric Measurements: Mid-upper arm circumference (MUAC) and calf circumference (CC) will be performed by a single investigator using a non-stretchable measuring tape recorded to the nearest 0.1 cm. Values will be obtained at baseline (within 24 hours), day 7 (or at extubation/discharge if earlier), and on the day of weaning.

Diaphragmatic Ultrasonography: Bedside point-of-care ultrasound using a high-frequency linear probe (7-13 MHz) will evaluate the diaphragm in the zone of apposition at the 8th-9th intercostal space on the right hemithorax. Diaphragm thickness at end-expiration (Tdi,ee) and end-inspiration (Tdi,pi) will be measured in B-mode/M-mode (averaging three consecutive cycles) at baseline, day 7, and during spontaneous breathing trials/weaning attempts.

02

Conditions studied

  • Chronic Obstructive Pulmonary Disease (COPD)
  • Acute Exacerbation of Chronic Obstructive Pulmonary Disease
  • Malnutrition
  • Respiratory Failure
  • Ventilator-Induced Diaphragmatic Dysfunction

Keywords

  • modified NUTRIC score
  • Diaphragmatic ultrasound
  • Diaphragm thickness
  • Mechanical ventilation
  • Mid-upper arm circumference
  • Calf circumference
  • Sarcopenia
  • Weaning failure
  • APACHE II
  • SOFA score
03

In context

Pulmonary Disease, Chronic Obstructive

5,520 studies on the registry are indexed under Pulmonary Disease, Chronic Obstructive; 856 are open to participants now.

This study's planned enrollment of 120 is below the median of 158 across 1,497 observational studies indexed under Pulmonary Disease, Chronic Obstructive.

Browse Pulmonary Disease, Chronic Obstructive studies →

Lead sponsor

Assiut University is the lead sponsor of 5,078 studies on the registry; 2,178 are open to participants now.

Of its 14 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
60 Years and older
Sexes eligible
All
Sampling method
Non-probability sample

Study population

Elderly patients aged 60 years or older with acute exacerbation of chronic obstructive pulmonary disease (COPD) admitted to the Chest Department and ICU/respiratory ICU at Assiut University Hospital who require invasive mechanical ventilation for at least 48 hours.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Adult patients aged ≥ 60 years
  • Confirmed diagnosis of (COPD) according to GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria
  • Admission to the intensive care unit (ICU) or respiratory ICU for acute exacerbation of COPD
  • Requirement for invasive mechanical ventilation for ≥ 48 hours
  • Provision of by the patient or a first-degree relative/legal guardian

Exclusion criteria

Exclusion Criteria:

  • Pre-existing neuromuscular disease affecting diaphragmatic or peripheral muscle function (e.g., myasthenia gravis, muscular dystrophy, poliomyelitis, motor neuron disease)
  • Known diaphragmatic paralysis or phrenic nerve injury predating admission
  • Severe limb edema, amputation, or lower-limb deformity precluding valid anthropometric measurement
  • Terminal illness or with an expected survival of \< 48 hours
  • Duration of mechanical ventilation \< 48 hours, or death/extubation occurring before baseline assessment completion
  • Subcutaneous emphysema or thoracic/abdominal wall pathology precluding adequate diaphragmatic ultrasound acoustic windows
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
120 participants (estimated)
Patient registry
No

Groups and cohorts

  • Mechanically Ventilated Elderly COPD Patients

    Adult patients aged 60 years or older with a confirmed diagnosis of COPD admitted to the ICU/respiratory ICU for acute exacerbation and requiring invasive mechanical ventilation for at least 48 hours. Participants undergo baseline severity scoring (mNUTRIC, SOFA, APACHE II), serial anthropometric assessments (MUAC, calf circumference), and diaphragmatic ultrasonography (diaphragm thickness at end-expiration and end-inspiration) at baseline, day 7, and during spontaneous breathing trials/weaning.

06

What researchers measure

Primary outcomes

  1. Baseline End-Expiratory Diaphragmatic Thickness

    Diaphragm thickness measured in millimeters (mm) at end-expiration (Tdi,ee) using B-mode/M-mode bedside ultrasonography in the zone of apposition (8th-9th intercostal space between the anterior and mid-axillary lines). The average of three consecutive measurements will be reported and evaluated in relation to the baseline modified NUTRIC score (scores range from 0 to 9, where scores ≥ 5 indicate high nutritional risk).

    Time frame: Baseline

07

Study locations

No study locations are listed for this record.

08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Oct 2026; primary completion for Oct 2027, 12 months later.

Of 466 non-industry observational studies under Pulmonary Disease, Chronic Obstructive, half reached primary completion within 29 months of starting (the median), counting those still running; a quarter within 15 and three quarters within 64. This study's planned 12 months is below that.

Counting every sponsor, half of 586 studies reached it within 26 months; a quarter within 14 and three quarters within 58.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 22, 2026
First posted
Aug 26, 2026
StartEst.
Oct 2026
Primary completionEst.
Oct 2027
CompletionEst.
Nov 2027
Last update
Aug 26, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 26, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT07788170
Lead sponsor
Assiut University
Responsible party
Ziad Mohamed Esmail Abdel-Aal (Resident of Chest Diseases, Assiut University) — Principal investigator
First posted
Aug 26, 2026
Start date
Oct 2026 (estimated)
Primary completion
Oct 2027 (estimated)
Completion
Nov 2027 (estimated)
Last update
Aug 26, 2026
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

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