Neurally adjusted ventilatory assist improves patient–ventilator interaction
| العنوان: | Neurally adjusted ventilatory assist improves patient–ventilator interaction |
|---|---|
| المؤلفون: | Laurence Vignaux, D. Tassaux, Lise Piquilloud, Pierre-François Laterre, Emilie Bialais, Jean Roeseler, Thierry Sottiaux, Philippe Jolliet |
| المصدر: | Intensive Care Medicine. 37:263-271 |
| بيانات النشر: | Springer Science and Business Media LLC, 2010. |
| سنة النشر: | 2010 |
| مصطلحات موضوعية: | Male, medicine.medical_treatment, Diaphragm, Diaphragmatic breathing, Critical Care and Intensive Care Medicine, Intermittent Positive-Pressure Ventilation, Interquartile range, Intensive care, medicine, Neurally adjusted ventilatory assist, Humans, Prospective Studies, Aged, Mechanical ventilation, Electromyography, business.industry, Signal Processing, Computer-Assisted, Equipment Design, Middle Aged, Respiration, Artificial, body regions, Anesthesia, Respiratory Mechanics, Breathing, Female, Respiratory Insufficiency, business, Airway, Interactive Ventilatory Support |
| الوصف: | 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. 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. 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). 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. |
| تدمد: | 1432-1238 0342-4642 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5e2ffa3be4b7880a6a6d4472cf710eb8 https://doi.org/10.1007/s00134-010-2052-9 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....5e2ffa3be4b7880a6a6d4472cf710eb8 |
| قاعدة البيانات: | OpenAIRE |
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