Pressure Support Ventilation (PSV) Versus Neurally Adjusted Ventilatory Assist (NAVA) in Difficult to Wean Pediatric ARDS Patients: a Physiologic Crossover Study
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Distress Respiratory Syndrome
- Sponsor
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS
- Enrollment
- 12
- Primary Endpoint
- asynchrony index
- Status
- Completed
- Last Updated
- 4 years ago
Overview
Brief Summary
This study assessed the effects of NAVA versus Pressure Support Ventilation (PSV) on patient-ventilator interaction in pediatric patients with difficult weaning from mechanical ventilation after moderate Pediatric Acute Respiratory Distress Syndrome (PARDS).
Detailed Description
12 pediatric patients, admitted in Pediatric Intensive Care Unit (PICU) with moderate PARDS and who failed up to 3 SBTs in less than 7 days, were enrolled in this study. These patients underwent three studies conditions, lasting 1 hour each: Pressure support ventilation 1, Neurally adjusted ventilatory assist and Pressure support ventilation 2. During each trial were recorded the patient tracings of flow, airway pressure and electrical activity of diaphragm for the patient-ventilator interaction analysis.
Investigators
SPINAZZOLA GIORGIA
Medical doctor, specialist in Anesthesia and Intensive Care Medicine
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Eligibility Criteria
Inclusion Criteria
- •diagnosis of moderate PARDS
- •3 spontaneous breathing trials failed in less than 7 days
Exclusion Criteria
- •hemodynamic instability
- •severe respiratory instability
- •contraindication to nasogastric tube exchange
- •increase in intracranial pressure
- •palliative care for end-stage oncologic disease
- •neuromuscular disease
- •lesions of medulla
Outcomes
Primary Outcomes
asynchrony index
Time Frame: three years
in each study condition, the asynchrony index was measured. The asynchrnony index value grater than 10% is an indicator of worsening patient-ventilator interaction. the Asynchrony Index is the ratio between the number of asynchronous events and the total respiratory rate, expressed as percentage
Secondary Outcomes
- patient-ventilator interaction(three years)
- interaction(three years)
- synchrony between patient and mechanical ventilator(three years)