-
Journal of critical care · Apr 2014
Neurally adjusted ventilatory assist vs pressure support ventilation in infants recovering from severe acute respiratory distress syndrome: Nested study.
- Marco Piastra, Laura Marzano, Alessandro Pizza, and Federico Visconti.
- Paediatric Intensive Care Unit.
- J Crit Care. 2014 Apr 1;29(2):312.e1-5.
ObjectiveNeurally adjusted ventilatory assist (NAVA) is a new ventilator modality with an innovative synchronization technique. Our aim is to verify if NAVA is feasible and safe in terms of physiological and clinical variables in infants recovering from severe acute respiratory distress syndrome (ARDS).DesignThis is a pilot nested study to help future trial design.SettingThe study was performed in third-level academic pediatric intensive care units.PatientsInfants affected by severe ARDS requiring high-frequency ventilation and weaned with NAVA during 2010 were included. Controls (2:1 ratio) were ARDS infants weaned with pressure support ventilation (PSV) during 2008-2009 matched for age, gas exchange impairment, and weight.Main Outcome MeasuresThe main outcome measures were the physiological and ventilator parameters and the duration of ventilator support in PSV or NAVA.ResultsTen infants treated with NAVA and 20 with PSV were studied. Heart rate (P < .001) and mean arterial pressure (P < .001) increased less during NAVA than during PSV. Similarly, Pao2/Fio2 ratio decreased less in NAVA than in PSV (P < .001). Neurally adjusted ventilatory assist also resulted in lower Paco2 (P < .001) and peak pressure (P = .001), as well as higher minute ventilation (P = .013). COMFORT score (P = .004) and duration of support were lower in NAVA than in PSV (P = .011).ConclusionsNeurally adjusted ventilatory assist is safe and suitable in infants recovering from severe ARDS. It could provide better results than PSV and is worth to be investigated in a multicenter randomized trial.© 2014 Elsevier Inc. All rights reserved.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*
,_underline_
or**bold**
. - Superscript can be denoted by
<sup>text</sup>
and subscript<sub>text</sub>
. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3.
, hyphens-
or asterisks*
. - Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:
![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
- For footnotes use
[^1](This is a footnote.)
inline. - Or use an inline reference
[^1]
to refer to a longer footnote elseweher in the document[^1]: This is a long footnote.
.