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Neurally adjusted ventilatory assist (NAVA) improves patient–ventilator interaction during non-invasive ventilation delivered by face mask
| Content Provider | Semantic Scholar |
|---|---|
| Author | Piquilloud, Lise Tassaux, Didier Bialais, Emilie Lambermont, Bernard C. Sottiaux, Thierry Roeseler, Jean Jolliet, Philippe Revelly, Jean-Pierre |
| Copyright Year | 2012 |
| Abstract | PurposeTo determine if, compared to pressure support (PS), neurally adjusted ventilatory assist (NAVA) reduces patient–ventilator asynchrony in intensive care patients undergoing noninvasive ventilation with an oronasal face mask.MethodsIn this prospective interventional study we compared patient–ventilator synchrony between PS (with ventilator settings determined by the clinician) and NAVA (with the level set so as to obtain the same maximal airway pressure as in PS). Two 20-min recordings of airway pressure, flow and electrical activity of the diaphragm during PS and NAVA were acquired in a randomized order. Trigger delay (Td), the patient’s neural inspiratory time (Tin), ventilator pressurization duration (Tiv), inspiratory time in excess (Tiex), number of asynchrony events per minute and asynchrony index (AI) were determined.ResultsThe study included 13 patients, six with COPD, and two with mixed pulmonary disease. Td was reduced with NAVA: median 35 ms (IQR 31–53 ms) versus 181 ms (122–208 ms); p = 0.0002. NAVA reduced both premature and delayed cyclings in the majority of patients, but not the median Tiex value. The total number of asynchrony events tended to be reduced with NAVA: 1.0 events/min (0.5–3.1 events/min) versus 4.4 events/min (0.9–12.1 events/min); p = 0.08. AI was lower with NAVA: 4.9 % (2.5–10.5 %) versus 15.8 % (5.5–49.6 %); p = 0.03. During NAVA, there were no ineffective efforts, or late or premature cyclings. PaO2 and PaCO2 were not different between ventilatory modes.ConclusionCompared to PS, NAVA improved patient ventilator synchrony during noninvasive ventilation by reducing Td and AI. Moreover, with NAVA, ineffective efforts, and late and premature cyclings were absent. |
| Starting Page | 1624 |
| Ending Page | 1631 |
| Page Count | 8 |
| File Format | PDF HTM / HTML |
| DOI | 10.1007/s00134-012-2626-9 |
| Alternate Webpage(s) | http://orbi.ulg.ac.be/bitstream/2268/140021/1/Piquiloud%20L,%20Intensive%20Care%20Med,%202012%20Aug.pdf |
| PubMed reference number | 22885649 |
| Alternate Webpage(s) | https://doi.org/10.1007/s00134-012-2626-9 |
| Journal | Medline |
| Volume Number | 38 |
| Journal | Intensive Care Medicine |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
