Abstract | OBJECTIVE: DESIGN: This is a pilot nested study to help future trial design. SETTING: The study was performed in third-level academic pediatric intensive care units. PATIENTS: Infants 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 MEASURES: The main outcome measures were the physiological and ventilator parameters and the duration of ventilator support in PSV or NAVA. RESULTS: Ten 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). CONCLUSIONS:
Neurally 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.
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Authors | Marco Piastra, Daniele De Luca, Roberta Costa, Alessandro Pizza, Renata De Sanctis, Laura Marzano, Daniele Biasucci, Federico Visconti, Giorgio Conti |
Journal | Journal of critical care
(J Crit Care)
Vol. 29
Issue 2
Pg. 312.e1-5
(Apr 2014)
ISSN: 1557-8615 [Electronic] United States |
PMID | 24209903
(Publication Type: Journal Article)
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Copyright | © 2014 Elsevier Inc. All rights reserved. |
Chemical References |
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Topics |
- Case-Control Studies
- Feasibility Studies
- High-Frequency Ventilation
(adverse effects, methods)
- Humans
- Hypnotics and Sedatives
(administration & dosage)
- Infant
- Intensive Care Units, Pediatric
- Interactive Ventilatory Support
(adverse effects, methods)
- Pilot Projects
- Severe Acute Respiratory Syndrome
(therapy)
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