Nava enhances ventilatory variability and diaphragmatic activity/tidal volume coupling

Détails

ID Serval
serval:BIB_3037BA8E27B1
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Abstract (résumé de présentation): article court qui reprend les éléments essentiels présentés à l'occasion d'une conférence scientifique dans un poster ou lors d'une intervention orale.
Collection
Publications
Institution
Titre
Nava enhances ventilatory variability and diaphragmatic activity/tidal volume coupling
Titre de la conférence
23rd Annual Meeting of the European Society of Intensive Care Medicine
Auteur(s)
Moorhead K., Piquilloud L., Desaive T., Roeseler J., Chase J.G., Vignaux L., Bialais E., Tassaux D., Jolliet P., Lambermont B.
Adresse
Barcelona, Spain, October 9-13, 2010
ISBN
0342-4642
Statut éditorial
Publié
Date de publication
2010
Peer-reviewed
Oui
Volume
36
Série
Intensive Care Medicine
Pages
S326
Langue
anglais
Notes
Meeting Abstract
Résumé
INTRODUCTION. Neurally Adjusted Ventilatory Assist (NAVA) is a new ventilatory mode in which ventilator settings are adjusted based on the electrical activity detected in the diaphragm (Eadi). This mode offers significant advantages in mechanical ventilation over standard pressure support (PS) modes, since ventilator input is determined directly from patient ventilatory demand. Therefore, it is expected that tidal volume (Vt) under NAVA would show better correlation with Eadi compared with PS, and exhibit greater variability due to the variability in the Eadi input to the ventilator.
OBJECTIVES. To compare tidal volume variability in PS and NAVA ventilation modes, and its correlation with patient ventilatory demand (as characterized by maximum Eadi).
METHODS. Acomparative study of patient-ventilator interaction was performed for 22 patients during standard PS with clinician determined ventilator settings; and NAVA, with NAVA gain set to ensure the same peak airway pressure as the total pressure obtained in PS. A 20 min continuous recording was performed in each ventilator mode. Respiratory rate, Vt, and Eadi were recorded. Tidal volume variance and Pearson correlation coefficient between Vt and Eadi were calculated for each patient. A periodogram was plotted for each ventilator mode and each patient, showing spectral power as a function of frequency to assess variability.
RESULTS. Median, lower quartile and upper quartile values for Vt variance and Vt/Eadi correlation are shown in Table 1. The NAVA cohort exhibits substantially greater correlation and variance than the PS cohort. Power spectrums for Vt and Eadi are shown in Fig. 1 (PS and NAVA) for a typical patient. The enlarged section highlights how changes in Eadi are highly synchronized with NAVA ventilation, but less so for PS.
CONCLUSIONS. There is greater variability in tidal volume and correlation between tidal volume and diaphragmatic electrical activity with NAVA compared to PS. These results are consistent with the improved patient-ventilator synchrony reported in the literature.
Web of science
Création de la notice
11/11/2010 15:52
Dernière modification de la notice
20/08/2019 13:14
Données d'usage