Abstract | BACKGROUND: METHODS: Fifteen patients, the majority of whom underwent abdominal surgery, were enrolled. They were ventilated with PSV and NAVA for 24 h each in a randomized crossover order. The ventilatory parameters and gas exchange effects produced by the two ventilation modes were compared. The variability of the ventilatory parameters was also evaluated by the coefficient of variation (SD to mean ratio). RESULTS: Two patients failed to shift to NAVA because of postoperative bilateral diaphragmatic paralysis, and one patient interrupted the study because of worsening of his sickness. In the other 12 cases, the 48 h of the study protocol were completed, using both ventilation modes, with no signs of intolerance or complications. The Pao2/Fio2 (mean ± SD) ratio in NAVA was significantly higher than with PSV (264 ± 71 vs. 230 ± 75 mmHg, P < 0.05). Paco2 did not differ significantly between the two modes. The tidal volume (median [interquartile range]) with NAVA was significantly lower than with PSV (7.0 [6.4-8.6] vs. 6.5 [6.3-7.4] ml/kg predicted body weight, P < 0.05).Variability of insufflation airway pressure, tidal volume, and minute ventilation were significantly higher with NAVA than with PSV. Electrical activity of the diaphragm variability was significantly lower with NAVA than with PSV. CONCLUSIONS: Compared with PSV, respiratory parameter variability was greater with NAVA, probably leading in part to the significant improvement in patient oxygenation.
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Authors | Yannael Coisel, Gerald Chanques, Boris Jung, Jean-Michel Constantin, Xavier Capdevila, Stefan Matecki, Salvatore Grasso, Samir Jaber |
Journal | Anesthesiology
(Anesthesiology)
Vol. 113
Issue 4
Pg. 925-35
(Oct 2010)
ISSN: 1528-1175 [Electronic] United States |
PMID | 20823760
(Publication Type: Journal Article, Randomized Controlled Trial)
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Critical Care
(methods)
- Critical Illness
- Cross-Over Studies
- Electrocardiography
- Female
- Humans
- Male
- Middle Aged
- Monitoring, Physiologic
- Oxygen Consumption
(physiology)
- Postoperative Complications
(physiopathology)
- Prospective Studies
- Pulmonary Gas Exchange
- Respiration, Artificial
(methods)
- Respiratory Mechanics
(physiology)
- Ventilator Weaning
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