Pressure Support Ventilation (PSV) Versus Neurally Adjusted Ventilatory Assist (NAVA) in Difficult to Wean Pediatric ARDS Patients: a Physiologic Crossover Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 12
- 主要终点
- asynchrony index
研究概览
简要总结
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).
详细描述
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.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Crossover
- 时间视角
- Prospective
入排标准
- 年龄范围
- 1 Month 至 2 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •diagnosis of moderate PARDS
- •3 spontaneous breathing trials failed in less than 7 days
排除标准
- •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
结局指标
主要结局
asynchrony index
时间窗: 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
次要结局
- patient-ventilator interaction(three years)
- interaction(three years)
- synchrony between patient and mechanical ventilator(three years)
研究者
SPINAZZOLA GIORGIA
Medical doctor, specialist in Anesthesia and Intensive Care Medicine
Fondazione Policlinico Universitario Agostino Gemelli IRCCS