Asset Details
Do you wish to reserve the book?
Asynchrony, neural drive, ventilatory variability and COMFORT: NAVA versus pressure support in pediatric patients. A non-randomized cross-over trial
Hey, we have placed the reservation for you!
By the way, why not check out events that you can attend while you pick your title.
Oops! Something went wrong.
Looks like we were not able to place the reservation. Kindly try again later.
Are you sure you want to remove the book from the shelf?
Asynchrony, neural drive, ventilatory variability and COMFORT: NAVA versus pressure support in pediatric patients. A non-randomized cross-over trial
Do you wish to request the book?
Asynchrony, neural drive, ventilatory variability and COMFORT: NAVA versus pressure support in pediatric patients. A non-randomized cross-over trial
Please be aware that the book you have requested cannot be checked out. If you would like to checkout this book, you can reserve another copy
We have requested the book for you!
Your request is successful and it will be processed during the Library working hours. Please check the status of your request in My Requests.
Oops! Something went wrong.
Looks like we were not able to place your request. Kindly try again later.
Journal Article
Asynchrony, neural drive, ventilatory variability and COMFORT: NAVA versus pressure support in pediatric patients. A non-randomized cross-over trial
2012
Overview
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.
Publisher
Springer-Verlag,Springer,Springer Nature B.V
Subject
/ Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
/ Biological and medical sciences
/ Children
/ Dyspnea
/ Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care
/ Female
/ Humans
/ Infant
/ Intensive Care Units, Pediatric
/ Interactive Ventilatory Support - instrumentation
/ Interactive Ventilatory Support - standards
/ Male
/ Medicine
/ Patients
/ Pneumology/Respiratory System
/ Positive-Pressure Respiration - instrumentation
/ Positive-Pressure Respiration - standards
/ Spain
