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1. Neurally adjusted ventilatory assist (NAVA) versus pressure support ventilation: patient-ventilator interaction during invasive ventilation delivered by tracheostomy

Author

Olivier Lamouret, Laure Crognier, Fanny Vardon Bounes, Jean-Marie Conil, Caroline Dilasser, Thibaut Raimondi, Stephanie Ruiz, Antoine Rouget, Clément Delmas, Thierry Seguin, Vincent Minville, and Bernard Georges

Subjects
Neurally adjusted ventilatory assist, Pressure support, Tracheostomy, Difficult weaning, Patient-ventilator asynchronies, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Prolonged weaning is a major issue in intensive care patients and tracheostomy is one of the last resort options. Optimized patient-ventilator interaction is essential to weaning. The purpose of this study was to compare patient-ventilator synchrony between pressure support ventilation (PSV) and neurally adjusted ventilatory assist (NAVA) in a selected population of tracheostomised patients. Methods We performed a prospective, sequential, non-randomized and single-centre study. Two recording periods of 60 min of airway pressure, flow, and electrical activity of the diaphragm during PSV and NAVA were recorded in a random assignment and eight periods of 1 min were analysed for each mode. We searched for macro-asynchronies (ineffective, double, and auto-triggering) and micro-asynchronies (inspiratory trigger delay, premature, and late cycling). The number and type of asynchrony events per minute and asynchrony index (AI) were determined. The two respiratory phases were compared using the non-parametric Wilcoxon test after testing the equality of the two variances (F-Test). Results Among the 61 patients analysed, the total AI was lower in NAVA than in PSV mode: 2.1% vs 14% (p

Published
2019
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2. Neurally adjusted ventilatory assist (NAVA) versus pressure support ventilation: patient-ventilator interaction during invasive ventilation delivered by tracheostomy

Author

Fanny Vardon Bounes, Caroline Dilasser, Stéphanie Ruiz, Olivier Lamouret, Bernard Georges, Jean-Marie Conil, Thibaut Raimondi, Clément Delmas, Laure Crognier, Thierry Seguin, Antoine Rouget, and Vincent Minville

Subjects
Male, medicine.medical_specialty, Pressure support, Respiratory rate, Population, Pressure support ventilation, Critical Care and Intensive Care Medicine, Severity of Illness Index, Positive-Pressure Respiration, 03 medical and health sciences, 0302 clinical medicine, Tracheostomy, Intensive care, Internal medicine, Neural Pathways, Neurally adjusted ventilatory assist, Medicine, Weaning, Humans, Prospective Studies, education, Interactive Ventilatory Support, Tidal volume, Aged, education.field_of_study, Simplified Acute Physiology Score, Noninvasive Ventilation, business.industry, Research, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, lcsh:RC86-88.9, Middle Aged, Difficult weaning, Respiration, Artificial, Breathing, Cardiology, Female, Patient-ventilator asynchronies, France, business, Ventilator Weaning
Abstract

Background Prolonged weaning is a major issue in intensive care patients and tracheostomy is one of the last resort options. Optimized patient-ventilator interaction is essential to weaning. The purpose of this study was to compare patient-ventilator synchrony between pressure support ventilation (PSV) and neurally adjusted ventilatory assist (NAVA) in a selected population of tracheostomised patients. Methods We performed a prospective, sequential, non-randomized and single-centre study. Two recording periods of 60 min of airway pressure, flow, and electrical activity of the diaphragm during PSV and NAVA were recorded in a random assignment and eight periods of 1 min were analysed for each mode. We searched for macro-asynchronies (ineffective, double, and auto-triggering) and micro-asynchronies (inspiratory trigger delay, premature, and late cycling). The number and type of asynchrony events per minute and asynchrony index (AI) were determined. The two respiratory phases were compared using the non-parametric Wilcoxon test after testing the equality of the two variances (F-Test). Results Among the 61 patients analysed, the total AI was lower in NAVA than in PSV mode: 2.1% vs 14% (p

Published
2018

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