Purpose: To determine if neurally adjusted ventilatory assist (NAVA) improves asynchrony, ventilatory drive, breath-to-breath variability and COMFORT score when compared to pressure support (PS).
Methods: This is a non-randomized short-term cross-over trial in which 12 pediatric patients with asynchrony (auto-triggering, double triggering or non-triggered breaths) were enrolled. Four sequential 10-min periods of data were recorded after 20 min of ventilatory stabilization (wash-out) at each of the following settings: baseline PS with the ventilator settings determined by the attending physician (1-PS(b)); PS after optimization (2-PS(opt)); NAVA level set so that maximum inspiratory pressure (P(max)) equaled P(max) in PS (3-NAVA); same settings as in 2-PS(opt) (4-PS(opt)).
Results: The median asynchrony index was significantly lower during NAVA (2.0%) than during 2-PS(opt) (8.5%, p = 0.017) and 4-PS(opt) (7.5%, p = 0.008). In NAVA mode, the NAVA trigger accounted on average for 66% of triggered breaths. The median trigger delay with respect to neural inspiratory time was significantly lower during NAVA (8.6%) than during 2-PS(opt) (25.2%, p = 0.003) and 4-PS(opt) (28.2%, p = 0.0005). The median electrical activity of the diaphragm (EAdi) change during trigger delay normalized to maximum inspiratory EAdi difference was significantly lower during NAVA (5.3%) than during 2-PS(opt) (21.7%, p = 0.0005) and 4-PS(opt) (24.6%, p = 0.001). The coefficient of variation of tidal volume was significantly higher during NAVA (44.2%) than during 2-PS(opt) (19.8%, p = 0.0002) and 4-PS(opt) (23.0%, p = 0.0005). The median COMFORT score during NAVA (15.0) was lower than that during 2-PS(opt) (18.0, p = 0.0125) and 4-PS(opt) (17.5, p = 0.039). No significant changes for any variable were observed between 1-PS(b) and 2-PS(opt).
Conclusions: Neurally adjusted ventilatory assist as compared to optimized PS results in improved synchrony, reduced ventilatory drive, increased breath-to-breath mechanical variability and improved patient comfort.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7094903 | PMC |
| http://dx.doi.org/10.1007/s00134-012-2535-y | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Mineral composition in mussel and clam from Faro Lake of Messina: risk assessment for human health.
Front Toxicol
December 2024
Department of Veterinary Sciences, University of Messina, Messina, Italy.
Bivalve are exposed to a wide range of contaminants, some of which may be toxic to human health. The aim of this study was to detect essential and non-essential elements such as Na, Ca, Mg, Cr, Mn, Fe, Ni, Cu, Zn, As, Cd, Pb, Hg, Be and Co in water, sediments, and and from Faro Lake. It is a lake of marine origin located on the northern coast of Messina (Sicily), where shellfish farming has been practiced for many years.
View Article and Find Full Text PDFNeurally adjusted ventilatory assist improves survival, and its early application accelerates weaning in preterm infants.
Pediatr Int
December 2024
Department of Pediatrics, Korea University Anam Hospital, Seoul, South Korea.
Background: Evidence to show that neurally adjusted ventilatory assist (NAVA) improves clinical outcomes is lacking. We aimed to analyze whether NAVA improves respiratory outcomes in preterm infants who require invasive mechanical ventilation.
Methods: A retrospective cohort study was conducted in 122 very low birthweight infants who required invasive mechanical ventilation for more than 24 h at one tertiary neonatal intensive care unit in Korea from January 2016 to June 2023.
Land surface temperature and socioeconomic residential segregation in the Metropolitan Zone of San Luis Potosí, Mexico.
Sci Total Environ
December 2024
Departamento de Geografía, Facultad de Ciencias Sociales y Humanidades, Universidad Autónoma de San Luis Potosí, Av.Industrias #101-A Fracc. Talleres, CP 78399 San Luis Potosí, Mexico. Electronic address:
Economic growth and urban sprawl in territorial systems produce an uneven distribution of infrastructure and services. This creates residential areas with high capital gains that are affordable only for the middle and upper classes. For lower-income groups, the only options are depressed urban areas with limited infrastructure.
View Article and Find Full Text PDFExperimental Lung Transplantation Related With HIF-1, VEGF, ROS. Assessment of HIF-1alpha, VEGF, and Reactive Oxygen Species After Competitive Blockade of Chetomin for Lung Transplantation in Rats.
Physiol Res
November 2024
Experimental Surgery Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga #15 Belisario Dominguez, Mexico City.
Unlabelled: Primary graft failure occurs 15 to 30 % of the time after transplantation. Although there have been improvements in preserving the lungs in good condition, there have not been studies on the regulation of transcription factors.
Methods: We carried out an experimental study involving lung transplantation to indirectly evaluate reactive oxygen species (ROS) production and VEGF expression by competitive blockade of HIF-1alpha with chetomin.
Vitamin D serum levels in patients with systemic sclerosis and very early systemic sclerosis (VEDOSS).
J Scleroderma Relat Disord
August 2024
Department of Advanced Medical and Surgical Sciences, "Luigi Vanvitelli" University of Campania, Naples, Italy.
Introduction: Vitamin D may be capable of interfering with the pathophysiological pathways involved in systemic sclerosis, by virtue of its well-known immunomodulatory effects. In this study, we aimed at evaluating the differences and the correlations between vitamin D levels in systemic sclerosis patients versus patients with very early systemic sclerosis.
Methods: One hundred twenty-six patients (80 definite systemic sclerosis and 46 very early systemic sclerosis) were included in this case control study.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!