| Patient-ventilator interaction during neurally adjusted ventilatory assist in low birth weight infants. | |
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MedLine Citation:
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PMID: 19218884 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Neurally adjusted ventilatory assist (NAVA), a mode of mechanical ventilation controlled by diaphragmatic electrical activity (EAdi), may improve patient-ventilator interaction. We examined patient-ventilator interaction by comparing EAdi to ventilator pressure during conventional ventilation (CV) and NAVA delivered invasively and non-invasively. Seven intubated infants [birth weight 936 g (range, 676-1266 g); gestational age 26 wk (range, 25-29)] were studied before and after extubation, initially during CV and then NAVA. NAVA-intubated and NAVA-extubated demonstrated similar delays between onset of EAdi and onset of ventilator pressure of 74 +/- 17 and 72 +/- 23 ms (p = 0.698), respectively. During CV, the mean trigger delays were not different from NAVA, however 13 +/- 8.5% of ventilator breaths were triggered on average 59 +/- 27 ms before onset of EAdi. There was no difference in off-cycling delays between NAVA-intubated and extubated (32 +/- 34 versus 28 +/- 11 ms). CV cycled-off before NAVA (120 +/- 66 ms prior, p < 0.001). During NAVA, EAdi and ventilator pressure were correlated [mean determination coefficient (NAVA-intubated 0.8 +/- 0.06 and NAVA-extubated 0.73 +/- 0.22)]. Pressure delivery during conventional ventilation was not correlated to EAdi. Neural expiratory time was longer (p = 0.044), and respiratory rate was lower (p = 0.004) during NAVA. We conclude that in low birth weight infants, NAVA can improve patient-ventilator interaction, even in the presence of large leaks. |
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Authors:
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Jennifer Beck; Maureen Reilly; Giacomo Grasselli; Lucia Mirabella; Arthur S Slutsky; Michael S Dunn; Christer Sinderby |
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Publication Detail:
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Type: Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Pediatric research Volume: 65 ISSN: 1530-0447 ISO Abbreviation: Pediatr. Res. Publication Date: 2009 Jun |
Date Detail:
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Created Date: 2009-05-20 Completed Date: 2009-08-17 Revised Date: 2010-09-23 |
Medline Journal Info:
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Nlm Unique ID: 0100714 Medline TA: Pediatr Res Country: United States |
Other Details:
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Languages: eng Pagination: 663-8 Citation Subset: IM |
Affiliation:
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Keenan Research Centre, St Michael's Hospital, Toronto, Ontario, Canada. beckj@smh.toronto.on.ca |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Diaphragm*
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innervation,
physiology Gestational Age Humans Infant, Low Birth Weight* Infant, Newborn Infant, Premature Intubation, Intratracheal / methods Premature Birth Respiration, Artificial / methods* Respiratory Mechanics Signal Processing, Computer-Assisted* |
| Grant Support | |
ID/Acronym/Agency:
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1 R21 HD45047-01/HD/NICHD NIH HHS; R21 HD045047-01/HD/NICHD NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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