| Neurally adjusted ventilatory assist improves patient-ventilator interaction. | |
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MedLine Citation:
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PMID: 20871978 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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PURPOSE: To determine if, compared with pressure support (PS), neurally adjusted ventilatory assist (NAVA) reduces trigger delay, inspiratory time in excess, and the number of patient-ventilator asynchronies in intubated patients. METHODS: Prospective interventional study in spontaneously breathing patients intubated for acute respiratory failure. Three consecutive periods of ventilation were applied: (1) PS1, (2) NAVA, (3) PS2. Airway pressure, flow, and transesophageal diaphragmatic electromyography were continuously recorded. RESULTS: All results are reported as median (interquartile range, IQR). Twenty-two patients were included, 36.4% (8/22) having obstructive pulmonary disease. NAVA reduced trigger delay (ms): NAVA, 69 (57-85); PS1, 178 (139-245); PS2, 199 (135-256). NAVA improved expiratory synchrony: inspiratory time in excess (ms): NAVA, 126 (111-136); PS1, 204 (117-345); PS2, 220 (127-366). Total asynchrony events were reduced with NAVA (events/min): NAVA, 1.21 (0.54-3.36); PS1, 3.15 (1.18-6.40); PS2, 3.04 (1.22-5.31). The number of patients with asynchrony index (AI) >10% was reduced by 50% with NAVA. In contrast to PS, no ineffective effort or late cycling was observed with NAVA. There was less premature cycling with NAVA (events/min): NAVA, 0.00 (0.00-0.00); PS1, 0.14 (0.00-0.41); PS2, 0.00 (0.00-0.48). More double triggering was seen with NAVA, 0.78 (0.46-2.42); PS1, 0.00 (0.00-0.04); PS2, 0.00 (0.00-0.00). CONCLUSIONS: Compared with standard PS, NAVA can improve patient-ventilator synchrony in intubated spontaneously breathing intensive care patients. Further studies should aim to determine the clinical impact of this improved synchrony. |
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Authors:
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Lise Piquilloud; Laurence Vignaux; Emilie Bialais; Jean Roeseler; Thierry Sottiaux; Pierre-François Laterre; Philippe Jolliet; Didier Tassaux |
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Publication Detail:
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Type: Journal Article Date: 2010-09-25 |
Journal Detail:
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Title: Intensive care medicine Volume: 37 ISSN: 1432-1238 ISO Abbreviation: Intensive Care Med Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-01-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 263-71 Citation Subset: IM |
Affiliation:
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Intensive Care Unit, Clinical Research Laboratory, University Hospital, Faculty of Medicine, University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland, Lise.Piquilloud@hcuge.ch. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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