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https://www.readbyqxmd.com/read/29164144/intensive-care-unit-patients-with-lower-respiratory-tract-nosocomial-infections-the-enirris-project
#1
Gennaro De Pascale, Otavio T Ranzani, Saad Nseir, Jean Chastre, Tobias Welte, Massimo Antonelli, Paolo Navalesi, Eugenio Garofalo, Andrea Bruni, Luis Miguel Coelho, Szymon Skoczynski, Federico Longhini, Fabio Silvio Taccone, David Grimaldi, Helmut J F Salzer, Christoph Lange, Filipe Froes, Antoni Artigas, Emili Díaz, Jordi Vallés, Alejandro Rodríguez, Mauro Panigada, Vittoria Comellini, Luca Fasano, Paolo M Soave, Giorgia Spinazzola, Charles-Edouard Luyt, Francisco Alvarez-Lerma, Judith Marin, Joan Ramon Masclans, Davide Chiumello, Angelo Pezzi, Marcus Schultz, Hafiz Mohamed, Menno Van Der Eerden, Roger A S Hoek, D A M P J Gommers, Marta Di Pasquale, Rok Civljak, Marko Kutleša, Matteo Bassetti, George Dimopoulos, Stefano Nava, Fernando Rios, Fernando G Zampieri, Pedro Povoa, Lieuwe D Bos, Stefano Aliberti, Antoni Torres, Ignacio Martín-Loeches
The clinical course of intensive care unit (ICU) patients may be complicated by a large spectrum of lower respiratory tract infections (LRTI), defined by specific epidemiological, clinical and microbiological aspects. A European network for ICU-related respiratory infections (ENIRRIs), supported by the European Respiratory Society, has been recently established, with the aim at studying all respiratory tract infective episodes except community-acquired ones. A multicentre, observational study is in progress, enrolling more than 1000 patients fulfilling the clinical, biochemical and radiological findings consistent with a LRTI...
October 2017: ERJ Open Research
https://www.readbyqxmd.com/read/29115949/neurally-adjusted-ventilatory-assist-nava-or-pressure-support-ventilation-psv-during-spontaneous-breathing-trials-in-critically-ill-patients-a-crossover-trial
#2
Juliana C Ferreira, Fabia Diniz-Silva, Henrique T Moriya, Adriano M Alencar, Marcelo B P Amato, Carlos R R Carvalho
BACKGROUND: Neurally Adjusted Ventilatory Assist (NAVA) is a proportional ventilatory mode that uses the electrical activity of the diaphragm (EAdi) to offer ventilatory assistance in proportion to patient effort. NAVA has been increasingly used for critically ill patients, but it has not been evaluated during spontaneous breathing trials (SBT). We designed a pilot trial to assess the feasibility of using NAVA during SBTs, and to compare the breathing pattern and patient-ventilator asynchrony of NAVA with Pressure Support (PSV) during SBTs...
November 7, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29077984/neurally-adjusted-ventilatory-assist-compared-to-other-forms-of-triggered-ventilation-for-neonatal-respiratory-support
#3
REVIEW
Thomas E Rossor, Katie A Hunt, Sandeep Shetty, Anne Greenough
BACKGROUND: Effective synchronisation of infant respiratory effort with mechanical ventilation may allow adequate gas exchange to occur at lower peak airway pressures, potentially reducing barotrauma and volutrauma and development of air leaks and bronchopulmonary dysplasia. During neurally adjusted ventilatory assist ventilation (NAVA), respiratory support is initiated upon detection of an electrical signal from the diaphragm muscle, and pressure is provided in proportion to and synchronous with electrical activity of the diaphragm (EADi)...
October 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29072677/the-impact-of-neurally-adjusted-ventilatory-assist-mode-on-respiratory-severity-score-and-energy-expenditure-in-infants-a-randomized-crossover-trial
#4
J L Rosterman, E K Pallotto, W E Truog, H Escobar, K A Meinert, A Holmes, H Dai, W M Manimtim
OBJECTIVE: Examine respiratory severity scores (RSS) (mean airway pressure × fraction of inspired oxygen) and resting energy expenditure (REE) on neurally adjusted ventilatory assist (NAVA) compared with synchronized intermittent mandatory ventilation with pressure controlled and supported breath (SIMV (PC)PS). STUDY DESIGN: A randomized, crossover trial in a level IV neonatal intensive care unit. Twenty-four patients were ventilated with NAVA or SIMV (PC) PS for 12 h and then crossed over to the alternative mode for 12 h...
October 26, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29059880/evaluation-of-indirect-measures-of-neural-inspiratory-time-from-invasive-and-noninvasive-recordings-of-respiratory-activity
#5
Daniel Garcia-Castellote, Abel Torres, Luis Estrada, Leonardo Sarlabous, Raimon Jane
Measuring diaphragmatic electromyography (EMGdi) provides an indirect quantification of neural respiratory drive and allows the delimitation of diaphragm neural activation and deactivation during inspiration. EMGdi recordings have been incorporated in novel modes of assisted mechanical ventilation, such as neurally adjusted ventilatory assist (NAVA), to trigger and cycle-off the ventilator. The EMGdi signal improves the assistance delivered by more conventional ventilatory modes, in which the ventilator is synchronized with the patient employing a pneumatic triggering...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28977137/dorsal-brainstem-syndrome-and-the-use-of-neurally-adjusted-ventilatory-assist-nava-in-an-infant
#6
José Colleti, Walter Koga, Werther Brunow de Carvalho
OBJECTIVE: To report a rare case of dorsal brainstem syndrome in an infant after hypoxic-ischemic episode due to severe sepsis and the use of neurally adjusted ventilatory assist (NAVA) to aid in diagnosis and in the removal of mechanical ventilation. CASE DESCRIPTION: A 2-month-old male infant, previously healthy, presented with severe sepsis that evolved to dorsal brainstem syndrome, which usually occurs after hypoxic-ischemic injury in neonates and infants, and is related to very specific magnetic resonance images...
September 21, 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
https://www.readbyqxmd.com/read/28860265/official-ers-ats-clinical-practice-guidelines-noninvasive-ventilation-for-acute-respiratory-failure
#7
Bram Rochwerg, Laurent Brochard, Mark W Elliott, Dean Hess, Nicholas S Hill, Stefano Nava, Paolo Navalesi, Massimo Antonelli, Jan Brozek, Giorgio Conti, Miquel Ferrer, Kalpalatha Guntupalli, Samir Jaber, Sean Keenan, Jordi Mancebo, Sangeeta Mehta, Suhail Raoof
Noninvasive mechanical ventilation (NIV) is widely used in the acute care setting for acute respiratory failure (ARF) across a variety of aetiologies. This document provides European Respiratory Society/American Thoracic Society recommendations for the clinical application of NIV based on the most current literature.The guideline committee was composed of clinicians, methodologists and experts in the field of NIV. The committee developed recommendations based on the GRADE (Grading, Recommendation, Assessment, Development and Evaluation) methodology for each actionable question...
August 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28683763/new-setting-of-neurally-adjusted-ventilatory-assist-for-noninvasive-ventilation-by-facial-mask-a-physiologic-study
#8
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/28679616/i-want-to-break-free-liberation-from-noninvasive-ventilation
#9
EDITORIAL
Stefano Nava, Begum Ergan
No abstract text is available yet for this article.
July 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28673877/remifentanil-effects-on-respiratory-drive-and-timing-during-pressure-support-ventilation-and-neurally-adjusted-ventilatory-assist
#10
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
#11
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
#12
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/28515969/application-of-selective-bronchial-intubation-versus-neurally-adjusted-ventilatory-assist-in-the-management-of-unilateral-pulmonary-interstitial-emphysema-an-illustrative-case-and-the-literature-review
#13
Shing-Yan Robert Lee
In the treatment of left-sided pulmonary interstitial emphysema (PIE) in a 23-week neonate, we used two ventilatory strategies: selective bronchial intubation from day 10 to 15 and neurally adjusted ventilatory assist (NAVA) from day 18 to 26. We compared the effects and adverse effects of these two strategies. On selective bronchial intubation, desaturation was frequent. Fentanyl infusion was required. There was an episode of carbon dioxide retention coupled with hypotension. On NAVA, the neonate was clinically stable without the requirement of sedation...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28399118/feasibility-and-physiological-effects-of-noninvasive-neurally-adjusted-ventilatory-assist-in-preterm-infants
#14
Christopher K Gibu, Phillip Y Cheng, Raymond J Ward, Benjamin Castro, Gregory P Heldt
BackgroundNoninvasive 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.MethodsThe pilot protocol applied NIV-NAVA to 11 infants on nasal CPAP, high-flow nasal cannula, or nasal intermittent mandatory ventilation (NIMV), in multiple 2- to 4-h periods of NIV-NAVA for comparison. This provided the necessary data to design a randomized, controlled observational crossover study in eight additional infants to compare the physiological effects of NIV-NAVA with NIMV during 2-h steady-state conditions...
October 2017: Pediatric Research
https://www.readbyqxmd.com/read/28196820/combined-use-of-neurally-adjusted-ventilatory-assist-nava-and-vertical-expandable-prostethic-titanium-rib-veptr-in-a-patient-with-spondylocostal-dysostosis-and-associated-bronchomalacia
#15
Martí Pons-Odena, Alba Verges, Natalia Arza, Francisco José Cambra
Jarcho-Levin syndrome is a rare disorder characterised by defects in vertebral and costal segmentation of varying severity. Respiratory complications are the main cause of death or severe comorbidity due to a restrictive rib cage. A 3 months old infant with Spondylocostal dysostosis and associated bronchomalacia experiencing severe asynchrony during the weaning process is reported. The Neurally Adjusted Ventilatory Assist (NAVA) mode was used to improve adaptation to mechanical ventilation after Vertical Expandable Prosthetic Titanium Ribs (VEPTRs) were implanted...
February 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28192893/non-invasive-ventilation-improves-respiratory-distress-in-children-with-acute-viral-bronchiolitis-a-systematic-review
#16
Yann Combret, Guillaume Prieur, Pascal LE Roux, Clément Médrinal
INTRODUCTION: Non-invasive ventilation (NIV) is a common treatment for bronchiolitis. However, consensus concerning its efficacy is lacking. The aim of this systematic review was to assess NIV effectiveness to reduce respiratory distress. Secondary objectives were to summarize the effects of NIV, identify predictive factors for failure and describe settings and applications. EVIDENCE ACQUISITION: Literature searches were conducted in MEDLINE/PubMed, PEDro, Cochrane, EMBASE, CINAHL, Web of Science, UpToDate, and SuDoc from 1990 to April 2015...
June 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28180985/crossover-study-of-assist-control-ventilation-and-neurally-adjusted-ventilatory-assist
#17
RANDOMIZED CONTROLLED TRIAL
Sandeep Shetty, Katie Hunt, Janet Peacock, Kamal Ali, Anne Greenough
Some studies of infants with acute respiratory distress have demonstrated that neurally adjusted ventilator assist (NAVA) had better short-term results compared to non-triggered or other triggered models. We determined if very prematurely born infants with evolving or established bronchopulmonary dysplasia (BPD) had a lower oxygenation index (OI) on NAVA compared to assist control ventilation (ACV). Infants were studied for 1 h each on each mode. At the end of each hour, blood gas analysis was performed and the OI calculated...
April 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28063223/neurally-adjusted-ventilatory-assist-for-infants-under-prolonged-ventilation
#18
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/27997251/changes-of-respiratory-mechanics-in-copd-patients-from-stable-state-to-acute-exacerbations-with-respiratory-failure
#19
Piero Ceriana, Michele Vitacca, Annalisa Carlucci, Mara Paneroni, Lara Pisani, Stefano Nava
Symptoms, clinical course, functional and biological data during an exacerbation of chronic obstructive pulmonary disease (EXCOPD) have been investigated, but data on physiological changes of respiratory mechanics during a severe exacerbation with respiratory acidosis requiring noninvasive mechanical ventilation (NIMV) are scant. The aim of this study was to evaluate changes of respiratory mechanics in COPD patients comparing data observed during EXCOPD with those observed during stable state in the recovery phase...
April 2017: COPD
https://www.readbyqxmd.com/read/27940767/effective-neurally-adjusted-ventilatory-assist-nava-ventilation-in-a-child-with-jeune-syndrome
#20
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
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