Reference : NAVA enhances tidal volume and diaphragmatic electro-myographic activity matching: a ...
Scientific journals : Article
Human health sciences : Anesthesia & intensive care
Human health sciences : General & internal medicine
http://hdl.handle.net/2268/131673
NAVA enhances tidal volume and diaphragmatic electro-myographic activity matching: a Range90 analysis of supply and demand
English
Moorhead, K. T. [Cardiovascular Research Center, University of Liege, Liege, Belgium]
Piquilloud, L. [Intensive Care and Burn Unit, University Hospital, Lausanne, Switzerland]
LAMBERMONT, Bernard mailto [Centre Hospitalier Universitaire de Liège - CHU > > Frais communs médecine >]
Roeseler, J. [Intensive Care Unit, Cliniques Universitaires St-Luc, Brussels, Belgium]
Chiew, Y. S. [Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand]
Chase, J. G. [Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand]
Revelly, J.-P. [Intensive Care and Burn Unit, University Hospital, Lausanne, Switzerland]
Bialais, E. [Intensive Care Unit, Cliniques Universitaires St-Luc, Brussels, Belgium]
Tassaux, D. [Intensive Care Unit, University Hospital, Geneva, Switzerland]
Laterre, P.-F. [Intensive Care Unit, Cliniques Universitaires St-Luc, Brussels, Belgium]
Jolliet, P. [Intensive Care and Burn Unit, University Hospital, Lausanne, Switzerland]
Sottiaux, T. [La Clinique Notre Dame de Grâce, Gosselies, Belgium]
Desaive, Thomas mailto [Université de Liège - ULg > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles >]
2013
Journal of Clinical Monitoring and Computing
27(1)
61-70
Yes (verified by ORBi)
International
1387-1307
[en] Matching ; Mechanical ventilation ; NAVA ; Patient-ventilator interaction ; Variability
[en] Neurally adjusted ventilatory assist (NAVA) is a ventilation assist mode that delivers pressure in proportionality to electrical activity of the diaphragm (Eadi). Compared to pressure support ventilation (PS), it improves patient-ventilator synchrony and should allow a better expression of patient's intrinsic respiratory variability. We hypothesize that NAVA provides better matching in ventilator tidal volume (Vt) to patients inspiratory demand. 22 patients with acute respiratory failure, ventilated with PS were included in the study. A comparative study was carried out between PS and NAVA, with NAVA gain ensuring the same peak airway pressure as PS. Robust coefficients of variation (CVR) for Eadi and Vt were compared for each mode. The integral of Eadi (sh{phonetic}Eadi) was used to represent patient's inspiratory demand. To evaluate tidal volume and patient's demand matching, Range90 = 5-95 % range of the Vt/sh{phonetic}Eadi ratio was calculated, to normalize and compare differences in demand within and between patients and modes. In this study, peak Eadi and sh{phonetic}Eadi are correlated with median correlation of coefficients, R > 0.95. Median sh{phonetic}Eadi, Vt, neural inspiratory time (Ti_
<br /> Neural), inspiratory time (Ti) and peak inspiratory pressure (PIP) were similar in PS and NAVA. However, it was found that individual patients have higher or smaller sh{phonetic}Eadi, Vt, Ti_
<br /> Neural, Ti and PIP. CVR analysis showed greater Vt variability for NAVA (p < 0.005). Range90 was lower for NAVA than PS for 21 of 22 patients. NAVA provided better matching of Vt to sh{phonetic}Eadi for 21 of 22 patients, and provided greater variability Vt. These results were achieved regardless of differences in ventilatory demand (Eadi) between patients and modes. © 2012 Springer Science+Business Media New York.
http://hdl.handle.net/2268/131673
also: http://hdl.handle.net/2268/140022
10.1007/s10877-012-9398-1

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