PURPOSE: The purpose of this study was to compare the effect of varying levels of assist during pressure support (PSV) and Neurally Adjusted Ventilatory Assist (NAVA) on the aeration of the dependent and non-dependent lung regions by means of Electrical Impedance Tomography (EIT). METHODS: We studied ten mechanically ventilated patients with Acute Lung Injury (ALI). Positive-End Expiratory Pressure (PEEP) and PSV levels were both 10 cm H₂O during the initial PSV step. Thereafter, we changed the inspiratory pressure to 15 and 5 cm H₂O during PSV. The electrical activity of the diaphragm (EAdi) during pressure support ten was used to define the initial NAVA gain (100 %). Thereafter, we changed NAVA gain to 150 and 50 %, respectively. After each step the assist level was switched back to PSV 10 cm H₂O or NAVA 100 % to get a new baseline. The EIT registration was performed continuously. RESULTS: Tidal impedance variation significantly decreased during descending PSV levels within patients, whereas not during NAVA. The dorsal-to-ventral impedance distribution, expressed according to the center of gravity index, was lower during PSV compared to NAVA. Ventilation contribution of the dependent lung region was equally in balance with the non-dependent lung region during PSV 5 cm H₂O, NAVA 50 and 100 %. CONCLUSION: Neurally Adjusted Ventilatory Assist ventilation had a beneficial effect on the ventilation of the dependent lung region and showed less over-assistance compared to PSV in patients with ALI.
PURPOSE: The purpose of this study was to compare the effect of varying levels of assist during pressure support (PSV) and Neurally Adjusted Ventilatory Assist (NAVA) on the aeration of the dependent and non-dependent lung regions by means of Electrical Impedance Tomography (EIT). METHODS: We studied ten mechanically ventilated patients with Acute Lung Injury (ALI). Positive-End Expiratory Pressure (PEEP) and PSV levels were both 10 cm H₂O during the initial PSV step. Thereafter, we changed the inspiratory pressure to 15 and 5 cm H₂O during PSV. The electrical activity of the diaphragm (EAdi) during pressure support ten was used to define the initial NAVA gain (100 %). Thereafter, we changed NAVA gain to 150 and 50 %, respectively. After each step the assist level was switched back to PSV 10 cm H₂O or NAVA 100 % to get a new baseline. The EIT registration was performed continuously. RESULTS: Tidal impedance variation significantly decreased during descending PSV levels within patients, whereas not during NAVA. The dorsal-to-ventral impedance distribution, expressed according to the center of gravity index, was lower during PSV compared to NAVA. Ventilation contribution of the dependent lung region was equally in balance with the non-dependent lung region during PSV 5 cm H₂O, NAVA 50 and 100 %. CONCLUSION: Neurally Adjusted Ventilatory Assist ventilation had a beneficial effect on the ventilation of the dependent lung region and showed less over-assistance compared to PSV in patients with ALI.
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: Nicolas Terzi; Iris Pelieu; Lydia Guittet; Michel Ramakers; Amélie Seguin; Cédric Daubin; Pierre Charbonneau; Damien du Cheyron; Frédéric Lofaso Journal: Crit Care Med Date: 2010-09 Impact factor: 7.598
Authors: Jadranka Spahija; Michel de Marchie; Martin Albert; Patrick Bellemare; Stéphane Delisle; Jennifer Beck; Christer Sinderby Journal: Crit Care Med Date: 2010-02 Impact factor: 7.598
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: Eduardo L V Costa; João Batista Borges; Alexandre Melo; Fernando Suarez-Sipmann; Carlos Toufen; Stephan H Bohm; Marcelo B P Amato Journal: Intensive Care Med Date: 2009-03-03 Impact factor: 17.440
Authors: Pedro de la Oliva; Cristina Schüffelmann; Ana Gómez-Zamora; Jesus Villar; Robert M Kacmarek Journal: Intensive Care Med Date: 2012-04-06 Impact factor: 17.440
Authors: Elie Azoulay; Giuseppe Citerio; Jan Bakker; Matteo Bassetti; Dominique Benoit; Maurizio Cecconi; J Randall Curtis; Glenn Hernandez; Margaret Herridge; Samir Jaber; Michael Joannidis; Laurent Papazian; Mark Peters; Pierre Singer; Martin Smith; Marcio Soares; Antoni Torres; Antoine Vieillard-Baron; Jean-François Timsit Journal: Intensive Care Med Date: 2014-01-24 Impact factor: 17.440
Authors: Francesca Campoccia Jalde; Fredrik Jalde; Peter V Sackey; Peter J Radell; Staffan Eksborg; Mats K E B Wallin Journal: Eur J Anaesthesiol Date: 2016-04 Impact factor: 4.330