Effect of Mechanical Ventilation With NAVA and PSV on Inspiratory Muscle Workload and Synchrony in Patients With Chronic Obstructive Pulmonary Disease
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 16
- 试验地点
- 4
- 主要终点
- Inspiratory muscle workload as reflected by the diaphragmatic Pressure Time Product (PTPdi)
研究概览
简要总结
NAVA used the electrical activity of the diaphragm (EAdi) to initiate and deliver in proportion of an inspiratory assistance. During inspiration, EAdi signal occurred earlier than airflow or pressure variations in the airway. The investigators hypothesized that NAVA improved patient-ventilator synchrony and reduced inspiratory workload as compared with pressure support ventilation delivered at two different cycling criteria (25 and 50 %).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •History of chronic obstructive pulmonary disease
- •Admitted for acute respiratory failure requiring invasive mechanical ventilation
- •Currently receiving pressure support ventilation
排除标准
- •Age < 18 years
- •Respiratory rate > 35 bpm
- •Severe hypoxemia with SpO2 < 88 % and FIO2 > 50 %
- •Heart rate > 120 bpm
- •Systolic arterial pressure < 90 mmHg
- •Contraindication to naso-gastric tube's insertion
研究组 & 干预措施
PSV-ET 25
Pressure support ventilation with expiratory trigger set at 25 %.
干预措施: Expiratory trigger (ET) (Other)
PSV-ET 50
Pressure support ventilation with expiratory cycling set at 50 %.
干预措施: Expiratory trigger (ET) (Other)
NAVA
NAVA level is adjusted to achieve similar peak inspiratory pressure levels than during PSV.
干预措施: NAVA (Device)
结局指标
主要结局
Inspiratory muscle workload as reflected by the diaphragmatic Pressure Time Product (PTPdi)
时间窗: 5 minutes
次要结局
- Arterial blood gases(20 minutes)
- Trigger delay(5 minutes)
- Ineffective inspiratory effort(5 minutes)
- Dynamic intrinsic PEEP(5 minutes)
研究者
Jerome Allardet-Servent, MD
MD, MSc
Hôpital Européen Marseille