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Neurally adjusted ventilatory support

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https://www.readbyqxmd.com/read/28683763/new-setting-of-neurally-adjusted-ventilatory-assist-for-noninvasive-ventilation-by-facial-mask-a-physiologic-study
#1
Federico Longhini, Chun Pan, Jianfeng Xie, Gianmaria Cammarota, Andrea Bruni, Eugenio Garofalo, Yi Yang, Paolo Navalesi, Haibo Qiu
BACKGROUND: Noninvasive ventilation (NIV) is generally delivered using pneumatically-triggered and cycled-off pressure support (PSP) through a mask. Neurally adjusted ventilatory assist (NAVA) is the only ventilatory mode that uses a non-pneumatic signal, i.e., diaphragm electrical activity (EAdi), to trigger and drive ventilator assistance. A specific setting to generate neurally controlled pressure support (PSN) was recently proposed for delivering NIV by helmet. We compared PSN with PSP and NAVA during NIV using a facial mask, with respect to patient comfort, gas exchange, and patient-ventilator interaction and synchrony...
July 7, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28673877/remifentanil-effects-on-respiratory-drive-and-timing-during-pressure-support-ventilation-and-neurally-adjusted-ventilatory-assist
#2
Roberta Costa, Paolo Navalesi, Gianmaria Cammarota, Federico Longhini, Giorgia Spinazzola, Flora Cipriani, Giuliano Ferrone, Olimpia Festa, Massimo Antonelli, Giorgio Conti
We assessed the effects of varying doses of remifentanil on respiratory drive and timing in patients receiving Pressure Support Ventilation (PSV) and Neurally Adjusted Ventilatory Assist (NAVA). Four incrementing remifentanil doses were randomly administered to thirteen intubated patients (0.03, 0.05, 0.08, and 0.1μg·Kg(-1)·min(-)1) during both PSV and NAVA. We measured the patient's (Ti/Ttotneu) and ventilator (Ti/Ttotmec) duty cycle, the Electrical Activity of the Diaphragm (EAdi), the inspiratory (Delaytrinsp) and expiratory (Delaytrexp) trigger delays and the Asynchrony Index (AI)...
July 1, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28608135/can-proportional-ventilation-modes-facilitate-exercise-in-critically-ill-patients-a-physiological-cross-over-study-pressure-support-versus-proportional-ventilation-during-lower-limb-exercise-in-ventilated-critically-ill-patients
#3
Evangelia Akoumianaki, Nicolas Dousse, Aissam Lyazidi, Jean-Claude Lefebvre, Severine Graf, Ricardo Luiz Cordioli, Nathalie Rey, Jean-Christophe Marie Richard, Laurent Brochard
BACKGROUND: Early exercise of critically ill patients may have beneficial effects on muscle strength, mass and systemic inflammation. During pressure support ventilation (PSV), a mismatch between demand and assist could increase work of breathing and limit exercise. A better exercise tolerance is possible with a proportional mode of ventilation (Proportional Assist Ventilation, PAV+ and Neurally Adjusted Ventilatory Assist, NAVA). We examined whether, in critically ill patients, PSV and proportional ventilation have different effects on respiratory muscles unloading and work efficiency during exercise...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28578708/effects-of-neurally-adjusted-ventilatory-assist-on-air-distribution-and-dead-space-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#4
Qin Sun, Ling Liu, Chun Pan, Zhanqi Zhao, Jingyuan Xu, Airan Liu, Haibo Qiu
BACKGROUND: Neurally adjusted ventilatory assist (NAVA) could improve patient-ventilator interaction; its effects on ventilation distribution and dead space are still unknown. The aim of this study was to evaluate the effects of varying levels of assist during NAVA and pressure support ventilation (PSV) on ventilation distribution and dead space in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: Fifteen mechanically ventilated patients with AECOPD were included in the study...
June 2, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28399118/feasibility-and-physiological-effects-of-non-invasive-neurally-adjusted-ventilatory-assist-niv-nava-in-preterm-infants
#5
Christopher Gibu, Phillip Cheng, Raymond J Ward, Benjamin Castro, Gregory P Heldt
BACKGROUND: Non-invasive Neurally Adjusted Ventilator Assist (NIV-NAVA) was introduced to our clinical practice via a pilot and a randomized observational study to assess its safety, feasibility, and short term physiological effects. METHODS: The pilot protocol applied NIV-NAVA to 11 infants on nasal CPAP, high-flow nasal cannula (HFNC), or nasal IMV (NIMV), in multiple 2-4 h periods of NIV-NAVA for comparison. This provided the necessary data to design a randomized, controlled observational cross-over study in 8 additional infants to compare the physiological effects of NIV-NAVA to NIMV during 2-hour steady state conditions...
April 11, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28063223/neurally-adjusted-ventilatory-assist-for-infants-under-prolonged-ventilation
#6
Juyoung Lee, Han-Suk Kim, Young Hwa Jung, Chang Won Choi, Yong Hoon Jun
BACKGROUND: Severe bronchopulmonary dysplasia often leads to prolonged mechanical ventilation lasting several months. Cyanotic episodes frequently occur in these patients, necessitating long-term sedation and/or intermittent muscle paralysis. Neurally adjusted ventilatory assist (NAVA) might provide precisely the amount of support that these patients need without sedation. METHODS: We reviewed the medical records of preterm infants who underwent tracheostomy and required mechanical ventilation for >6 months during a period of 6 years...
May 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27940767/effective-neurally-adjusted-ventilatory-assist-nava-ventilation-in-a-child-with-jeune-syndrome
#7
Gianluca Cosi, Giulia Genoni, Alice Monzani, Barbara Pilan, Maria Lavrano, Federica Ferrero
Jeune syndrome (asphyxiating thoracic dystrophy) is a rare skeletal dysplasia mainly characterized by dystrophy of the thoracic cage. Neurally adjusted ventilatory assist (NAVA) is a respiratory support in which pressure assistance is provided in proportion to and synchronous with the electrical activity of the diaphragm. We present the case of a 4-month-old infant with asphyxiating thoracic dystrophy and respiratory failure successfully ventilated with NAVA. In this case, NAVA improved patient-ventilator synchrony, reducing endotracheal secretion and gastric overdistention...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27919117/noninvasive-neurally-adjusted-ventilatory-assist-in-premature-infants-postextubation
#8
Tarah T Colaizy, Gary J Kummet, Colleen M Kummet, Jonathan M Klein
Background Neurally adjusted ventilatory assist (NAVA) has distinct advantages when used invasively compared with conventional ventilation techniques. Evidence supporting the use of noninvasive NAVA is less robust, especially in the very low birth weight (VLBW) population. Objective To determine whether synchronized noninvasive ventilation via neurally adjusted ventilatory assist (NIV NAVA) supports ventilation postextubation in premature infants. Methods A retrospective analysis of a cohort of twenty-four former VLBW (<1...
May 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/27918385/neurally-adjusted-ventilatory-assist-in-preterm-infants-with-established-or-evolving-bronchopulmonary-dysplasia-on-high-intensity-mechanical-ventilatory-support-a-single-center-experience
#9
Young Hwa Jung, Han-Suk Kim, Juyoung Lee, Seung Han Shin, Ee-Kyung Kim, Jung-Hwan Choi
OBJECTIVES: The aim of the present study was to report possible improvements in ventilator variables associated with a transition from synchronized intermittent mandatory ventilation to neurally adjusted ventilatory assist in preterm infants with bronchopulmonary dysplasia who required a high level of mechanical ventilatory support in a single center. DESIGN: Retrospective study. SETTING: Neonatal ICU. PATIENTS: Twenty-nine preterm infants with a median gestational age of 25...
December 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27866528/-effect-of-non-invasive-nava-on-the-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#10
D Q Wang, J Luo, X H Xiong, L H Zhu, W W Zhang
Objective: To observe the effect of non-invasive neurally adjusted ventilatory assist (NIV-NAVA) on patient-ventilator synchrony and effect of gas exchange in patients with acute exacerbation of chronic obstructive pulmonary disease compared with NIV-pressure support ventilation (PSV). Methods: This was a prospective study of 40 patients with AECOPD given 30-min trials of NIV with NIV-PSV group (n=20) and NAVA group (n=20) in random order. Arterial blood gas analysis (ABGs), main asynchrony events and asynchrony index were quantified...
November 15, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27749511/early-noninvasive-neurally-adjusted-ventilatory-assist-versus-noninvasive-flow-triggered-pressure-support-ventilation-in-pediatric-acute-respiratory-failure-a-physiologic-randomized-controlled-trial
#11
Giovanna Chidini, Daniele De Luca, Giorgio Conti, Paolo Pelosi, Stefano Nava, Edoardo Calderini
OBJECTIVE: Neurally adjusted ventilatory assist has been shown to improve patient-ventilator interaction in children with acute respiratory failure. Objective of this study was to compare the effect of noninvasive neurally adjusted ventilatory assist versus noninvasive flow-triggered pressure support on patient-ventilator interaction in children with acute respiratory failure, when delivered as a first-line respiratory support. DESIGN: Prospective randomized crossover physiologic study...
November 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27748627/partial-neuromuscular-blockade-during-partial-ventilatory-support-in-sedated-patients-with-high-tidal-volumes
#12
Jonne Doorduin, Joeke L Nollet, Lisanne H Roesthuis, Hieronymus W H van Hees, Laurent J Brochard, Christer A Sinderby, Johannes G van der Hoeven, Leo M A Heunks
RATIONALE: Controlled mechanical ventilation is used to deliver lung-protective ventilation in patients with acute respiratory distress syndrome. Despite recognized benefits, such as preserved diaphragm activity, partial support ventilation modes may be incompatible with lung-protective ventilation due to high Vt and high transpulmonary pressure. As an alternative to high-dose sedatives and controlled mechanical ventilation, pharmacologically induced neuromechanical uncoupling of the diaphragm should facilitate lung-protective ventilation under partial support modes...
April 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27686347/neurally-adjusted-ventilatory-assist-as-an-alternative-to-pressure-support-ventilation-in-adults-a-french-multicentre-randomized-trial
#13
A Demoule, M Clavel, C Rolland-Debord, S Perbet, N Terzi, A Kouatchet, F Wallet, H Roze, F Vargas, C Guerin, J Dellamonica, S Jaber, L Brochard, T Similowski
PURPOSE: Neurally adjusted ventilatory assist (NAVA) is a ventilatory mode that tailors the level of assistance delivered by the ventilator to the electromyographic activity of the diaphragm. The objective of this study was to compare NAVA and pressure support ventilation (PSV) in the early phase of weaning from mechanical ventilation. METHODS: A multicentre randomized controlled trial of 128 intubated adults recovering from acute respiratory failure was conducted in 11 intensive care units...
November 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27649505/new-setting-of-neurally-adjusted-ventilatory-assist-during-noninvasive-ventilation-through-a-helmet
#14
Gianmaria Cammarota, Federico Longhini, Raffaella Perucca, Chiara Ronco, Davide Colombo, Antonio Messina, Rosanna Vaschetto, Paolo Navalesi
BACKGROUND: Compared to pneumatically controlled pressure support (PSP), neurally adjusted ventilatory assist (NAVA) was proved to improve patient-ventilator interactions, while not affecting comfort, diaphragm electrical activity (EAdi), and arterial blood gases (ABGs). This study compares neurally controlled pressure support (PSN) with PSP and NAVA, delivered through two different helmets, in hypoxemic patients receiving noninvasive ventilation for prevention of extubation failure. METHODS: Fifteen patients underwent three (PSP, NAVA, and PSN) 30-min trials in random order with both helmets...
December 2016: Anesthesiology
https://www.readbyqxmd.com/read/27629375/comparing-changing-neurally-adjusted-ventilatory-assist-nava-levels-in-intubated-and-recently-extubated-neonates
#15
B LoVerde, K S Firestone, H M Stein
OBJECTIVE: Neurally adjusted ventilatory assist (NAVA) is a mode of mechanical ventilation that delivers ventilatory support in synchrony to the patient's respiratory needs using NAVA level, a proportionality constant that converts the electrical activity of the diaphragm (Edi) into a peak pressure (PIP). Recent published studies suggest that neonates can control the delivered ventilatory support through neural feedback. Systematically increasing the NAVA level initially increases the PIP while maintaining a constant Edi until an inflection point or breakpoint (BrP) is reached, at which time the PIP plateaus and the Edi signal decreases...
December 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27316915/french-intensive-care-society-international-congress-r%C3%A3-animation-2016
#16
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27290497/impact-of-the-assist-ventilation-mode-on-work-of-breathing-wob-neurally-adjusted-ventilatory-assist-nava-versus-pressure-support-ventilation-psv-versus-proportional-assist-ventilation-plus-pav
#17
R Di Mussi, S Spadaro, C A Volta, T Stripoli, A Armenise, L Pisani, R G Renna, A Civita, G Altamura, F Bruno, S Grasso
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27289959/comparison-of-neurally-adjusted-ventilatory-assist-and-pressure-support-ventilation-during-the-early-phase-of-weaning-from-mechanical-ventilation-a-randomised-controlled-study
#18
A Demoule, M Clavel, C Rolland-Debord, S Perbet, N Terzi, A Kouatchet, F Wallet, C Guerin, H Roze, F Vargas, J Dellamonica, S Jaber, T Similowski
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27093203/case-report-non-invasive-neurally-adjusted-ventilatory-assist-in-a-newborn-with-unilateral-diaphragmatic-paralysis
#19
Sander Roosens, Frank Derriks, Filip Cools
Diaphragmatic paralysis is a rare cause of respiratory distress in the newborn. In this paper, a patient with unilateral phrenic nerve injury after traumatic delivery is presented. The child inadequately responded to standard respiratory supportive measures. Non-invasive neurally adjusted ventilatory assist (NIV-NAVA®), providing an optimally synchronized respiratory support proportional to the effort of the patient, resulted in prompt clinical and biological improvement of the patient's respiratory condition...
November 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27090649/mechanical-ventilation-after-bidirectional-superior-cavopulmonary-anastomosis-for-single-ventricle-physiology-a-comparison-of-pressure-support-ventilation-and-neurally-adjusted-ventilatory-assist
#20
Limin Zhu, Zhuoming Xu, Xiaolei Gong, Jinghao Zheng, Yanjun Sun, Liping Liu, Lu Han, Haibo Zhang, Zhiwei Xu, Jinfen Liu, Peter C Rimensberger
We evaluated the effects of different respiratory assist modes on cerebral blood flow (CBF) and arterial oxygenation in single-ventricle patients after bidirectional superior cavopulmonary anastomosis (BCPA). We hypothesized that preserved auto-regulation of respiration during neurally adjusted ventilatory assist (NAVA) may have potential advantages for CBF and pulmonary blood flow regulation after the BCPA procedure. We enrolled 23 patients scheduled for BCPA, who underwent pressure-controlled ventilation (PCV), pressure support ventilation (PSV), and NAVA at two assist levels for all modes in a randomized order...
August 2016: Pediatric Cardiology
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