Aim: To compare physiological effects of NAVA with Pressure Support Ventilation (PSV) and Pressure Controlled Ventilation (PCV) in difficult-to wean patients (WPs). Methods: Six tracheostomised awake WPs (2 males, age 68.8±28.8y) under prolonged (>13 days) mechanical ventilation (MV) underwent physiological evaluation during three20 minute MV sessions, randomly applied, with NAVA, PSV and PCV. Airway pressure (Paw), airflow, and diaphragm electrical activity (EAdi) were derived from ventilator (Servo-i, Maquet). Changes in tidal volume (Vt), inspiratory (ITD) and expiratory (ETD) time delay, and EAdi-related work of breathing (WOB) due to ITD (WOBITD) and ETD (WOBETD) were analysed at maximal respiratory comfort (s1) and discomfort (s4) steps, as defined by dyspnoea Borg score >6). Results: In PSV, an increase in EAdipeak, WOB, and a decrease in Vt, Ve were observed from s1 to s4, unlike NAVA and PCV. In both steps, higher ETD and WOBETD in PCV compared to NAVA were found.
Vagheggini, G., Mazzoleni, S., Esposito, R., Carrozza, M., Ambrosino, N. (2014). Neurally Adjusted Ventilatory Assist (NAVA) in difficult-to wean patients. EUROPEAN RESPIRATORY JOURNAL, 38(Suppl 55), 5005-5005 [10.1183/13993003/erj.38.Suppl_55.p5005].
Neurally Adjusted Ventilatory Assist (NAVA) in difficult-to wean patients
Carrozza, MC;
2014
Abstract
Aim: To compare physiological effects of NAVA with Pressure Support Ventilation (PSV) and Pressure Controlled Ventilation (PCV) in difficult-to wean patients (WPs). Methods: Six tracheostomised awake WPs (2 males, age 68.8±28.8y) under prolonged (>13 days) mechanical ventilation (MV) underwent physiological evaluation during three20 minute MV sessions, randomly applied, with NAVA, PSV and PCV. Airway pressure (Paw), airflow, and diaphragm electrical activity (EAdi) were derived from ventilator (Servo-i, Maquet). Changes in tidal volume (Vt), inspiratory (ITD) and expiratory (ETD) time delay, and EAdi-related work of breathing (WOB) due to ITD (WOBITD) and ETD (WOBETD) were analysed at maximal respiratory comfort (s1) and discomfort (s4) steps, as defined by dyspnoea Borg score >6). Results: In PSV, an increase in EAdipeak, WOB, and a decrease in Vt, Ve were observed from s1 to s4, unlike NAVA and PCV. In both steps, higher ETD and WOBETD in PCV compared to NAVA were found.
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
