PURPOSE: To investigate the effect of a wide range of assistance levels during neurally adjusted ventilatory assist (NAVA) and pressure support ventilation (PSV) on respiratory pattern, breathing variability, and incidence of tidal volumes (V (T)) above 8 and 10 ml/kg in acute respiratory failure patients. METHODS: Eight increasing NAVA levels (0.5, 1, 1.5, 2, 2.5, 3, 4, and 5 cmH(2)O/μV) and four increasing pressure support (PSV) levels (4, 8, 12, and 16 cmH(2)O) were applied to obtain 10 min of stable recordings in 15 patients. RESULTS: One out of 15 patients did not sustain the NAVA levels of 3, 4, and 5 cmH(2)O/μV and was excluded. The 5 cmH(2)O/μV NAVA level was not tolerated by three patients and it was excluded. Increasing NAVA levels were associated with decreased diaphragm electrical activity (EAdi), and, at variance with PSV, with small changes in V (T), no changes in respiratory rate (RR), and increases in V (T) and EAdi variability. At high NAVA levels, an increase in V (T) variability was associated with increased incidence of V (T) above 8 and 10 ml/kg and an uncomfortable respiratory pattern in some patients. CONCLUSIONS: Increasing NAVA levels were associated with no effect on RR, small increase in V (T), and increase in V (T) and EAdi variability. Effective decrease in EAdi occurred at NAVA levels below 2-2.5 cmH(2)O/μV, while preserving respiratory variability and low risks of V (T) above 8 or 10 ml/kg.
PURPOSE: To investigate the effect of a wide range of assistance levels during neurally adjusted ventilatory assist (NAVA) and pressure support ventilation (PSV) on respiratory pattern, breathing variability, and incidence of tidal volumes (V (T)) above 8 and 10 ml/kg in acute respiratory failurepatients. METHODS: Eight increasing NAVA levels (0.5, 1, 1.5, 2, 2.5, 3, 4, and 5 cmH(2)O/μV) and four increasing pressure support (PSV) levels (4, 8, 12, and 16 cmH(2)O) were applied to obtain 10 min of stable recordings in 15 patients. RESULTS: One out of 15 patients did not sustain the NAVA levels of 3, 4, and 5 cmH(2)O/μV and was excluded. The 5 cmH(2)O/μV NAVA level was not tolerated by three patients and it was excluded. Increasing NAVA levels were associated with decreased diaphragm electrical activity (EAdi), and, at variance with PSV, with small changes in V (T), no changes in respiratory rate (RR), and increases in V (T) and EAdi variability. At high NAVA levels, an increase in V (T) variability was associated with increased incidence of V (T) above 8 and 10 ml/kg and an uncomfortable respiratory pattern in some patients. CONCLUSIONS: Increasing NAVA levels were associated with no effect on RR, small increase in V (T), and increase in V (T) and EAdi variability. Effective decrease in EAdi occurred at NAVA levels below 2-2.5 cmH(2)O/μV, while preserving respiratory variability and low risks of V (T) above 8 or 10 ml/kg.
Authors: Stephen P Arold; Rene Mora; Kenneth R Lutchen; Edward P Ingenito; Béla Suki Journal: Am J Respir Crit Care Med Date: 2002-02-01 Impact factor: 21.405
Authors: Christer Sinderby; Jennifer Beck; Jadranka Spahija; Michel de Marchie; Jacques Lacroix; Paolo Navalesi; Arthur S Slutsky Journal: Chest Date: 2007-03 Impact factor: 9.410
Authors: Peter M Spieth; Alysson R Carvalho; Paolo Pelosi; Catharina Hoehn; Christoph Meissner; Michael Kasper; Matthias Hübler; Matthias von Neindorff; Constanze Dassow; Martina Barrenschee; Stefan Uhlig; Thea Koch; Marcelo Gama de Abreu Journal: Am J Respir Crit Care Med Date: 2009-01-16 Impact factor: 21.405
Authors: W A Mutch; S Harms; M Ruth Graham; S E Kowalski; L G Girling; G R Lefevre Journal: Am J Respir Crit Care Med Date: 2000-07 Impact factor: 21.405
Authors: Nicoló Patroniti; Giuseppe Foti; Barbara Cortinovis; Elena Maggioni; Luca M Bigatello; Maurizio Cereda; Antonio Pesenti Journal: Anesthesiology Date: 2002-04 Impact factor: 7.892
Authors: Lukas Brander; Howard Leong-Poi; Jennifer Beck; Fabrice Brunet; Stuart J Hutchison; Arthur S Slutsky; Christer Sinderby Journal: Chest Date: 2008-11-18 Impact factor: 9.410
Authors: Giacomo Grasselli; Jennifer Beck; Lucia Mirabella; Antonio Pesenti; Arthur S Slutsky; Christer Sinderby Journal: Intensive Care Med Date: 2012-05-15 Impact factor: 17.440
Authors: Massimo Antonelli; Marc Bonten; Maurizio Cecconi; Jean Chastre; Giuseppe Citerio; Giorgio Conti; J R Curtis; Goran Hedenstierna; Michael Joannidis; Duncan Macrae; Salvatore M Maggiore; Jordi Mancebo; Alexandre Mebazaa; Jean-Charles Preiser; Patricia Rocco; Jean-François Timsit; Jan Wernerman; Haibo Zhang Journal: Intensive Care Med Date: 2013-01-22 Impact factor: 17.440