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Neurally adjusted ventilatory support

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https://www.readbyqxmd.com/read/27919117/noninvasive-neurally-adjusted-ventilatory-assist-in-premature-infants-postextubation
#1
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...
December 5, 2016: 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
#2
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
#3
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
#4
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
#5
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 tidal volume 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...
October 17, 2016: 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
#6
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
#7
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...
September 19, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27629375/comparing-changing-neurally-adjusted-ventilatory-assist-nava-levels-in-intubated-and-recently-extubated-neonates
#8
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
#9
(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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/27057312/roles-of-neurally-adjusted-ventilatory-assist-in-improving-gas-exchange-in-a-severe-acute-respiratory-distress-syndrome-patient-after-weaning-from-extracorporeal-membrane-oxygenation-a-case-report
#14
Yuya Goto, Shinshu Katayama, Atsuko Shono, Yosuke Mori, Yuya Miyazaki, Yoko Sato, Makoto Ozaki, Toru Kotani
BACKGROUND: Patient-ventilator asynchrony is a major cause of difficult weaning from mechanical ventilation. Neurally adjusted ventilatory assist (NAVA) is reported useful to improve the synchrony in patients with sustained low lung compliance. However, the role of NAVA has not been fully investigated. CASE PRESENTATION: The patient was a 63-year-old Japanese man with acute respiratory distress syndrome secondary to respiratory infection. He was treated with extracorporeal membrane oxygenation for 7 days and survived...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/26923501/physiology-of-non-invasive-respiratory-support
#15
REVIEW
Stamatia Alexiou, Howard B Panitch
Non-invasive ventilation (NIV) is used in neonates to treat extrathoracic and intrathoracic airway obstruction, parenchymal lung disease and disorders of control of breathing. Avoidance of airway intubation is associated with a reduction in the incidence of chronic lung disease among preterm infants with respiratory distress syndrome. Use of nasal continuous positive airway pressure (nCPAP) may help establish and maintain functional residual capacity (FRC), decrease respiratory work, and improve gas exchange...
June 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/26920146/carotid-body-chemoreceptors-sympathetic-neural-activation-and-cardiometabolic-disease
#16
REVIEW
Rodrigo Iturriaga, Rodrigo Del Rio, Juan Idiaquez, Virend K Somers
The carotid body (CB) is the main peripheral chemoreceptor that senses the arterial PO2, PCO2 and pH. In response to hypoxemia, hypercapnia and acidosis, carotid chemosensory discharge elicits reflex respiratory, autonomic and cardiovascular adjustments. The classical construct considers the CB as the main peripheral oxygen sensor, triggering reflex physiological responses to acute hypoxemia and facilitating the ventilatory acclimation to chronic hypoxemia at high altitude. However, a growing body of experimental evidence supports the novel concept that an abnormally enhanced CB chemosensory input to the brainstem contributes to overactivation of the sympathetic nervous system, and consequent pathology...
February 26, 2016: Biological Research
https://www.readbyqxmd.com/read/26899957/non-invasive-ventilation-with-neurally-adjusted-ventilatory-assist-in-newborns
#17
REVIEW
Howard Stein, Jennifer Beck, Michael Dunn
Neurally adjusted ventilatory assist (NAVA) is a mode of ventilation in which both the timing and degree of ventilatory assist are controlled by the patient. Since NAVA uses the diaphragm electrical activity (Edi) as the controller signal, it is possible to deliver synchronized non-invasive NAVA (NIV-NAVA) regardless of leaks and to monitor continuously patient respiratory pattern and drive. Advantages of NIV-NAVA over conventional modes include improved patient-ventilator interaction, reliable respiratory monitoring and self-regulation of respiratory support...
June 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/26785264/inhibitory-effect-of-nasal-intermittent-positive-pressure-ventilation-on-gastroesophageal-reflux
#18
Danny Cantin, Djamal Djeddi, Vincent Carrière, Nathalie Samson, Stéphanie Nault, Wan Lu Jia, Jennifer Beck, Jean-Paul Praud
Non-invasive intermittent positive pressure ventilation can lead to esophageal insufflations and in turn to gastric distension. The fact that the latter induces transient relaxation of the lower esophageal sphincter implies that it may increase gastroesophageal refluxes. We previously reported that nasal Pressure Support Ventilation (nPSV), contrary to nasal Neurally-Adjusted Ventilatory Assist (nNAVA), triggers active inspiratory laryngeal closure. This suggests that esophageal insufflations are more frequent in nPSV than in nNAVA...
2016: PloS One
https://www.readbyqxmd.com/read/26716863/neurally-adjusted-ventilatory-assist-feasibility-during-anaesthesia-a-randomised-crossover-study-of-two-anaesthetics-in-a-large-animal-model
#19
Francesca Campoccia Jalde, Fredrik Jalde, Peter V Sackey, Peter J Radell, Staffan Eksborg, Mats K E B Wallin
BACKGROUND: Spontaneous breathing during mechanical ventilation improves gas exchange by redistribution of ventilation to dependent lung regions. Neurally adjusted ventilatory assist (NAVA) supports spontaneous breathing in proportion to the electrical activity of the diaphragm (EAdi). NAVA has never been used in the operating room and no studies have systematically addressed the influence of different anaesthetic drugs on EAdi. OBJECTIVES: The aim of this study was to test the feasibility of NAVA under sedation and anaesthesia with two commonly used anaesthetics, sevoflurane and propofol, with and without remifentanil, and to study their effects on EAdi and breathing mechanics...
April 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/26698269/invasive-and-non-invasive-ventilation-for-prematurely-born-infants-current-practice-in-neonatal-ventilation
#20
Anne Greenough, Ingran Lingam
Non-invasive techniques, include nasal continuous positive airways pressure (nCPAP), nasal intermittent positive pressure ventilation (NIPPV) and heated, humidified, high flow cannula (HHFNC). Randomised controlled trials (RCTs) of nCPAP versus ventilation have given mixed results, but one demonstrated fewer respiratory problems during infancy. Meta-analysis demonstrated NIPPV rather than nCPAP provided better support post extubation. After extubation or initial support HHFNC has similar efficacy to CPAP. Invasive techniques include those that synchronise inflations with the patient's respiratory efforts...
February 2016: Expert Review of Respiratory Medicine
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