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Neurally Adjusted Ventilatory Assist (NAVA) improves patient-ventilator interaction in infants compared to conventional ventilation.
MedLine Citation:
PMID:  22580718     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background:Neurally Adjusted Ventilatory Assist (NAVA) is a mode of ventilation controlled by the electrical activity of the diaphragm (Edi). The aim was to evaluate patient-ventilator interaction in infants during NAVA compared to conventional ventilation.Methods:Infants were successively ventilated with NAVA, pressure control (PCV) and pressure support (PSV). Edi and ventilator pressure (Pvent) waveforms were compared and their variability was assessed by coefficients of variation (CV).Results:Ten patients (mean age 4.3±2.4 months and weight 5.9±2.2 kg) were studied. In PCV and PSV, 4±4.6% and 6.5±7.7% of the neural efforts failed to trigger the ventilator. This did not occur during NAVA. Trigger delays were shorter with NAVA compared to PCV and PSV (93±20ms vs 193±87ms, and 135±29ms). During PCV and PSV, the ventilator cycled off before end of neural inspiration in 12±13% and 21±19% of the breaths (0±0% during NAVA). During PCV and PSV, 24±11% and 25±9% of the neural breath cycle was asynchronous with the ventilator compared to 11±3% with NAVA. A large variability was observed for Edi in all modes, which was transmitted into Pvent during NAVA (CV: 24±8%), and not in PCV (CV 2±1%) or PSV (2±2%).Conclusions:NAVA improves patient-ventilator interaction and delivers adequate ventilation with variable pressure in infants.
Authors:
Alice Bordessoule; Guillaume Emeriaud; Sylvain Morneau; Philippe Jouvet; Jennifer Beck
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-11
Journal Detail:
Title:  Pediatric research     Volume:  -     ISSN:  1530-0447     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Pediatric Intensive Care, Sainte-Justine Hospital, Université de Montréal, Montréal, Quebec, Canada.
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