NAVA vs Pressure Support After Cardiac Surgery, a Physiological Study
Overview
- Phase
- N/A
- Intervention
- NAVA
- Conditions
- Ventilator Lung
- Sponsor
- Sahlgrenska University Hospital
- Enrollment
- 12
- Locations
- 2
- Primary Endpoint
- End expiratory lung impedance
- Status
- Completed
- Last Updated
- 8 days ago
Overview
Brief Summary
The study compares two different ventilation modes, Pressure support ventilation vs. Neuronally Adjusted Ventilatory Assist, in postcardiac surgery patients. Of special interest is shunt and alveolar deadspace and ventral vs. dorsal ventilation.
Detailed Description
The aim of the study is to compare two different ventilation modes in complicated postcardiac surgery patients, who need ventilatory support during weaning phase, in the Cardiothoracic Intensive Care Unit. The two different ventilation modes are Neuronally Adjusted Ventilatory Assist (NAVA) and Pressure Support ventilation. NAVA ventilation mode have been introduced a couple of years ago as an alternative to pressure support. The advantage of NAVA mode compared to pressure support is a better synchrony between patient and ventilator in the inspired and expired phases. Maybe there are also physiological advantages of the NAVA mode, which we want to study in the present study. All patients have three measurement periods. 1) Pressure support during 20 min, NAVA equilibration period of 30 min, followed by 2) NAVA ventilation for 20 min, pressure support equilibration period of 30 min and 3) pressure support for 20 min. Blood gases and cardiac output measurements is performed before and after each measurement period. Regional ventilation is measured by Electric Impedance Tomography (EIT).
Investigators
Andreas Martinsson
MD
Göteborg University
Eligibility Criteria
Inclusion Criteria
- •Complicated Post Cardiac surgery patients in the ventilator weaning phase.
- •Patients requiring assisted ventilation
- •Respiratory and circulatory stable patients
- •Sedated patients, RASS -2 to -3
Exclusion Criteria
- •Transplanted patients
- •Pleural effusion.
Arms & Interventions
NAVA vs Pressure Support
Control (pressure support) - NAVA - Control (Pressure Support) Intervention is NAVA
Intervention: NAVA
Outcomes
Primary Outcomes
End expiratory lung impedance
Time Frame: Through study completion, within approximately 18 months
Measured by Electric Impedance Tomography
Alveolar shunt
Time Frame: Through study completion, within approximately 18 months
Calculated from mixed venous and arterial blood gases
Ventilation distribution
Time Frame: Through study completion, within approximately 18 months
Redistribution of ventilation , dorsally vs. ventrally
Alveolar dead space
Time Frame: Through study completion, within approximately 18 months
Calculated from blood gases and end tidal pCO2,using standard formulae
PaO2/FiO2
Time Frame: Through study completion, within approximately 18 months
Arterial oxygenation