Al Giza

This research aims to study critically ill patients who require mechanical ventilation and face challenges with safely stopping this support. The study evaluates whether adding a measurement of parasternal intercostal muscle thickening helps decide the best timing to stop mechanical ventilation and reduces the risk of needing to be reintubated. This approach is being compared to the usual standard criteria for weaning from ventilation. Participants will be randomly assigned to one of two groups. One group will be weaned from mechanical ventilation using standard clinical criteria alone. The other group will use standard criteria plus an ultrasound measurement of the parasternal intercostal muscle thickening fraction, with a threshold of less than 6.5%. Ultrasound assessments are used to guide decisions, and the study is designed to keep participants and staff unaware of group assignments. During the study, researchers will monitor for reintubation within 72 hours after extubation and record cases of weaning failure in the same time frame. Participants will be evaluated closely with ultrasound and clinical assessments. The overall goal is to determine if adding this muscle measurement improves weaning outcomes. The study spans from screening through weaning and monitoring, with a targeted enrollment of adults aged 18 to 65 who have been mechanically ventilated for at least 24 hours.