Evaluation of the Clinical and Prognostic Value of Non-invasive Analysis of Mandibular Movements (MM) as a Marker of Inspiratory Effort in the Spontaneously Breathing Intensive Care Patient

Inclusion Criteria

• •Adult patients (≥ 18 years)
• •Admitted to the Intensive Care Unit for acute respiratory failure
• •On invasive mechanical ventilation for more than 24 hours with:
• •* A respiratory rate ≤ 35 breaths/minute;
• •* Adequate oxygenation, defined as either an oxygen saturation of at least 90% (obtained during ventilation with a fraction of inspired oxygen \[FiO2\] ≤ 40% and a positive end-expiratory pressure \[PEEP\] ≤ 8 cm of water) or an arterial partial pressure of oxygen (PaO2) (measured in mmHg) / FiO2 ratio \> 150 (obtained during ventilation with a PEEP ≤ 8 cm of water);
• •* Respiratory muscle capacity allowing for an effective cough;
• •* A state of wakefulness, defined as a Richmond Agitation and Sedation Scale (RASS) score of -2 to +1;
• •* No use of continuous sedation;
• •* No use of vasopressors (or use of minimal doses).
• •At high risk of weaning failure defined by at least one of the following criteria (5):
• •* Age \> 65 years
• •* A cardiac comorbidity among: systolic dysfunction (ejection fraction ≤45%), permanent atrial fibrillation, or a history of cardiogenic pulmonary edema or myocardial ischemia
• •* A respiratory comorbidity among: COPD, restrictive lung disease, or obesity hypoventilation syndrome
• •Written informed consent obtained from the patient, or in case of incapacity, from the next of kin/trusted person
• •Patient covered by social security