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. The primary outcome (RSS) and additional secondary respiratory outcomes were analyzed. RESULTS:RSS and measured REE were not different between modes. On NAVA, peak inspiratory pressures were lower (17.8 vs 19.9 cmH2O (P<0.05)) without higher oxygen requirements. Respiratory rates were higher on NAVA (52 vs 39 (P<0.05)), estimated work of breathing (WOB) (0.01 vs 0.04 J l-1 (P<0.05)) was improved. CONCLUSION: NAVA mode can be safe without increase in RSS or REE. Although respiratory rates were higher, this was offset by lower peak inspiratory pressures and WOB during NAVA.
RCT Entities:
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. The primary outcome (RSS) and additional secondary respiratory outcomes were analyzed. RESULTS:RSS and measured REE were not different between modes. On NAVA, peak inspiratory pressures were lower (17.8 vs 19.9 cmH2O (P<0.05)) without higher oxygen requirements. Respiratory rates were higher on NAVA (52 vs 39 (P<0.05)), estimated work of breathing (WOB) (0.01 vs 0.04 J l-1 (P<0.05)) was improved. CONCLUSION: NAVA mode can be safe without increase in RSS or REE. Although respiratory rates were higher, this was offset by lower peak inspiratory pressures and WOB during NAVA.
Authors: Manish B Malkar; William P Gardner; George T Mandy; Michael R Stenger; Leif D Nelin; Edward G Shepherd; Stephen E Welty Journal: Pediatr Pulmonol Date: 2014-03-10
Authors: P J Thureen; R E Phillips; M P DeMarie; A Hoffenberg; M N Bronstein; S B Spedale; W W Hay Journal: Crit Care Med Date: 1997-01 Impact factor: 7.598
Authors: Nilesh M Mehta; Lori J Bechard; Naomi Cahill; Miao Wang; Andrew Day; Christopher P Duggan; Daren K Heyland Journal: Crit Care Med Date: 2012-07 Impact factor: 7.598
Authors: Leeann R Pavlek; Brian K Rivera; Charles V Smith; Joanie Randle; Cory Hanlon; Kristi Small; Edward F Bell; Matthew A Rysavy; Sara Conroy; Carl H Backes Journal: J Pediatr Date: 2021-04-21 Impact factor: 6.314
Authors: Taylor P Hansen; Janelle Noel-MacDonnell; Sara Kuckelman; Michael Norberg; William Truog; Winston Manimtim Journal: J Perinatol Date: 2021-04-01 Impact factor: 3.225