Effects of Varying Levels of Inspiratory Assistance with Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist on Driving Pressure in Patients Recovering from Hypoxemic Respiratory Failure
Background Driving pressure can be readily measured during assisted modes of ventilation such as pressure support ventilation (PSV) and neurally adjusted ventilatory assist (NAVA). The present prospective randomized crossover study aimed to assess the changes in driving pressure in response to varia...
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| Veröffentlicht in: | Journal of clinical monitoring and computing 2022-04, Vol.36 (2), p.419-427 |
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| creator | Cammarota, Gianmaria Verdina, Federico De Vita, Nello Boniolo, Ester Tarquini, Riccardo Messina, Antonio Zanoni, Marta Navalesi, Paolo Vetrugno, Luigi Bignami, Elena Corte, Francesco Della De Robertis, Edoardo Santangelo, Erminio Vaschetto, Rosanna |
| description | Background
Driving pressure can be readily measured during assisted modes of ventilation such as pressure support ventilation (PSV) and neurally adjusted ventilatory assist (NAVA). The present prospective randomized crossover study aimed to assess the changes in driving pressure in response to variations in the level of assistance delivered by PSV vs NAVA.
Methods
16 intubated adult patients, recovering from hypoxemic acute respiratory failure (ARF) and undergoing assisted ventilation, were randomly subjected to six 30-min-lasting trials. At baseline, PSV (PSV100) was set with the same regulation present at patient enrollment. The corresponding level of NAVA (NAVA100) was set to match the same inspiratory peak of airway pressure obtained in PSV100. Therefore, the level of assistance was reduced and increased by 50% in both ventilatory modes (PSV50, NAVA50; PSV150, NAVA150). At the end of each trial, driving pressure obtained in response to four short (2–3 s) end-expiratory and end-inspiratory occlusions was analyzed.
Results
Driving pressure at PSV50 (6.6 [6.1–7.8] cmH
2
O) was lower than that recorded at PSV100 (7.9 [7.2–9.1] cmH
2
O,
P
= 0.005) and PSV150 (9.9 [9.1–13.2] cmH
2
O,
P
|
| doi_str_mv | 10.1007/s10877-021-00668-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7871131</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2487748876</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-3e2483d574532a9b2486f27036e448624b621a439a50a31900a7f6f559a028ec3</originalsourceid><addsrcrecordid>eNp9kktv1DAQxyMEog_4AhyQJS5cAn4ktnNBqkpLK62g4tGr5U0mrVdZO9jO0v2OfChmu2UXOHDyY37znxn7XxQvGH3DKFVvE6NaqZJyVlIqpS75o-KQ1UqUXLLqMe6FViUTVB0URyktKKWNFuxpcSBEXTdaVofFz7O-hzYnEnpybePa-RsygxUM9zeXPo0u2hzimpyk5FK2vgXyw-VbchUhpSkC-TKNY4iZXIPPbrDZBU-s78hHmKIdBszsFlPK0O2IvRxB9n10q03ZnaDz5AplEE7kM7RhBXET72NYkov1GO5g6VqM7Hs7t27AzGfFk94OCZ4_rMfFt_Ozr6cX5ezTh8vTk1nZVqrKpQBeadHVqqoFt80cT7LnigoJFW55NZec2Uo0tqZWsIZSq3rZ45NZyjW04rh4t9Udp_kSuhY7xUnNGN0Sn9AE68zfEe9uzU1YGaUVY4KhwOsHgRi-T5CyWbrUwjBYD2FKBjtSqtJaSURf_YMuwhQ9jme4lIpqprRAim-pNoaUIvS7Zhg1G7OYrVkMmsXcm8VwTHr55xi7lN_uQEBsgTRufgDivvZ_ZH8B_mXPqw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2667081783</pqid></control><display><type>article</type><title>Effects of Varying Levels of Inspiratory Assistance with Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist on Driving Pressure in Patients Recovering from Hypoxemic Respiratory Failure</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Cammarota, Gianmaria ; Verdina, Federico ; De Vita, Nello ; Boniolo, Ester ; Tarquini, Riccardo ; Messina, Antonio ; Zanoni, Marta ; Navalesi, Paolo ; Vetrugno, Luigi ; Bignami, Elena ; Corte, Francesco Della ; De Robertis, Edoardo ; Santangelo, Erminio ; Vaschetto, Rosanna</creator><creatorcontrib>Cammarota, Gianmaria ; Verdina, Federico ; De Vita, Nello ; Boniolo, Ester ; Tarquini, Riccardo ; Messina, Antonio ; Zanoni, Marta ; Navalesi, Paolo ; Vetrugno, Luigi ; Bignami, Elena ; Corte, Francesco Della ; De Robertis, Edoardo ; Santangelo, Erminio ; Vaschetto, Rosanna</creatorcontrib><description>Background
Driving pressure can be readily measured during assisted modes of ventilation such as pressure support ventilation (PSV) and neurally adjusted ventilatory assist (NAVA). The present prospective randomized crossover study aimed to assess the changes in driving pressure in response to variations in the level of assistance delivered by PSV vs NAVA.
Methods
16 intubated adult patients, recovering from hypoxemic acute respiratory failure (ARF) and undergoing assisted ventilation, were randomly subjected to six 30-min-lasting trials. At baseline, PSV (PSV100) was set with the same regulation present at patient enrollment. The corresponding level of NAVA (NAVA100) was set to match the same inspiratory peak of airway pressure obtained in PSV100. Therefore, the level of assistance was reduced and increased by 50% in both ventilatory modes (PSV50, NAVA50; PSV150, NAVA150). At the end of each trial, driving pressure obtained in response to four short (2–3 s) end-expiratory and end-inspiratory occlusions was analyzed.
Results
Driving pressure at PSV50 (6.6 [6.1–7.8] cmH
2
O) was lower than that recorded at PSV100 (7.9 [7.2–9.1] cmH
2
O,
P
= 0.005) and PSV150 (9.9 [9.1–13.2] cmH
2
O,
P
< 0.0001). In NAVA, driving pressure at NAVA50 was reduced compared to NAVA150 (7.7 [5.1–8.1] cmH
2
O vs 8.3 [6.4–11.4] cmH
2
O,
P
= 0.013), whereas there were no changes between baseline and NAVA150 (8.5 [6.3–9.8] cmH
2
O vs 8.3 [6.4–11.4] cmH
2
O,
P
= 0.331, respectively). Driving pressure at PSV150 was higher than that observed in NAVA150 (
P
= 0.011).
Conclusions
NAVA delivers better lung-protective ventilation compared to PSV in hypoxemic ARF patients.
Trial registration number and date of registration
The present trial was prospectively registered at
www.clinicatrials.gov
(NCT03719365) on 24 October 2018</description><identifier>ISSN: 1387-1307</identifier><identifier>EISSN: 1573-2614</identifier><identifier>DOI: 10.1007/s10877-021-00668-2</identifier><identifier>PMID: 33559864</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Adult ; Anesthesiology ; Critical Care Medicine ; Cross-Over Studies ; Health Sciences ; Humans ; Intensive ; Intensive care ; Interactive Ventilatory Support ; Lung ; Medicine ; Medicine & Public Health ; Mortality ; Original Research ; Patients ; Prospective Studies ; Respiration ; Respiratory failure ; Respiratory Insufficiency - therapy ; Statistical analysis ; Statistics for Life Sciences ; Ventilation ; Ventilators</subject><ispartof>Journal of clinical monitoring and computing, 2022-04, Vol.36 (2), p.419-427</ispartof><rights>The Author(s), under exclusive licence to Springer Nature B.V. part of Springer Nature 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer Nature B.V. part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer Nature B.V. part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-3e2483d574532a9b2486f27036e448624b621a439a50a31900a7f6f559a028ec3</citedby><cites>FETCH-LOGICAL-c474t-3e2483d574532a9b2486f27036e448624b621a439a50a31900a7f6f559a028ec3</cites><orcidid>0000-0001-9112-2705</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10877-021-00668-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10877-021-00668-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33559864$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cammarota, Gianmaria</creatorcontrib><creatorcontrib>Verdina, Federico</creatorcontrib><creatorcontrib>De Vita, Nello</creatorcontrib><creatorcontrib>Boniolo, Ester</creatorcontrib><creatorcontrib>Tarquini, Riccardo</creatorcontrib><creatorcontrib>Messina, Antonio</creatorcontrib><creatorcontrib>Zanoni, Marta</creatorcontrib><creatorcontrib>Navalesi, Paolo</creatorcontrib><creatorcontrib>Vetrugno, Luigi</creatorcontrib><creatorcontrib>Bignami, Elena</creatorcontrib><creatorcontrib>Corte, Francesco Della</creatorcontrib><creatorcontrib>De Robertis, Edoardo</creatorcontrib><creatorcontrib>Santangelo, Erminio</creatorcontrib><creatorcontrib>Vaschetto, Rosanna</creatorcontrib><title>Effects of Varying Levels of Inspiratory Assistance with Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist on Driving Pressure in Patients Recovering from Hypoxemic Respiratory Failure</title><title>Journal of clinical monitoring and computing</title><addtitle>J Clin Monit Comput</addtitle><addtitle>J Clin Monit Comput</addtitle><description>Background
Driving pressure can be readily measured during assisted modes of ventilation such as pressure support ventilation (PSV) and neurally adjusted ventilatory assist (NAVA). The present prospective randomized crossover study aimed to assess the changes in driving pressure in response to variations in the level of assistance delivered by PSV vs NAVA.
Methods
16 intubated adult patients, recovering from hypoxemic acute respiratory failure (ARF) and undergoing assisted ventilation, were randomly subjected to six 30-min-lasting trials. At baseline, PSV (PSV100) was set with the same regulation present at patient enrollment. The corresponding level of NAVA (NAVA100) was set to match the same inspiratory peak of airway pressure obtained in PSV100. Therefore, the level of assistance was reduced and increased by 50% in both ventilatory modes (PSV50, NAVA50; PSV150, NAVA150). At the end of each trial, driving pressure obtained in response to four short (2–3 s) end-expiratory and end-inspiratory occlusions was analyzed.
Results
Driving pressure at PSV50 (6.6 [6.1–7.8] cmH
2
O) was lower than that recorded at PSV100 (7.9 [7.2–9.1] cmH
2
O,
P
= 0.005) and PSV150 (9.9 [9.1–13.2] cmH
2
O,
P
< 0.0001). In NAVA, driving pressure at NAVA50 was reduced compared to NAVA150 (7.7 [5.1–8.1] cmH
2
O vs 8.3 [6.4–11.4] cmH
2
O,
P
= 0.013), whereas there were no changes between baseline and NAVA150 (8.5 [6.3–9.8] cmH
2
O vs 8.3 [6.4–11.4] cmH
2
O,
P
= 0.331, respectively). Driving pressure at PSV150 was higher than that observed in NAVA150 (
P
= 0.011).
Conclusions
NAVA delivers better lung-protective ventilation compared to PSV in hypoxemic ARF patients.
Trial registration number and date of registration
The present trial was prospectively registered at
www.clinicatrials.gov
(NCT03719365) on 24 October 2018</description><subject>Adult</subject><subject>Anesthesiology</subject><subject>Critical Care Medicine</subject><subject>Cross-Over Studies</subject><subject>Health Sciences</subject><subject>Humans</subject><subject>Intensive</subject><subject>Intensive care</subject><subject>Interactive Ventilatory Support</subject><subject>Lung</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Original Research</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Respiration</subject><subject>Respiratory failure</subject><subject>Respiratory Insufficiency - therapy</subject><subject>Statistical analysis</subject><subject>Statistics for Life Sciences</subject><subject>Ventilation</subject><subject>Ventilators</subject><issn>1387-1307</issn><issn>1573-2614</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kktv1DAQxyMEog_4AhyQJS5cAn4ktnNBqkpLK62g4tGr5U0mrVdZO9jO0v2OfChmu2UXOHDyY37znxn7XxQvGH3DKFVvE6NaqZJyVlIqpS75o-KQ1UqUXLLqMe6FViUTVB0URyktKKWNFuxpcSBEXTdaVofFz7O-hzYnEnpybePa-RsygxUM9zeXPo0u2hzimpyk5FK2vgXyw-VbchUhpSkC-TKNY4iZXIPPbrDZBU-s78hHmKIdBszsFlPK0O2IvRxB9n10q03ZnaDz5AplEE7kM7RhBXET72NYkov1GO5g6VqM7Hs7t27AzGfFk94OCZ4_rMfFt_Ozr6cX5ezTh8vTk1nZVqrKpQBeadHVqqoFt80cT7LnigoJFW55NZec2Uo0tqZWsIZSq3rZ45NZyjW04rh4t9Udp_kSuhY7xUnNGN0Sn9AE68zfEe9uzU1YGaUVY4KhwOsHgRi-T5CyWbrUwjBYD2FKBjtSqtJaSURf_YMuwhQ9jme4lIpqprRAim-pNoaUIvS7Zhg1G7OYrVkMmsXcm8VwTHr55xi7lN_uQEBsgTRufgDivvZ_ZH8B_mXPqw</recordid><startdate>20220401</startdate><enddate>20220401</enddate><creator>Cammarota, Gianmaria</creator><creator>Verdina, Federico</creator><creator>De Vita, Nello</creator><creator>Boniolo, Ester</creator><creator>Tarquini, Riccardo</creator><creator>Messina, Antonio</creator><creator>Zanoni, Marta</creator><creator>Navalesi, Paolo</creator><creator>Vetrugno, Luigi</creator><creator>Bignami, Elena</creator><creator>Corte, Francesco Della</creator><creator>De Robertis, Edoardo</creator><creator>Santangelo, Erminio</creator><creator>Vaschetto, Rosanna</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7SC</scope><scope>7SP</scope><scope>7U5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>JQ2</scope><scope>K7-</scope><scope>K9.</scope><scope>KB0</scope><scope>L7M</scope><scope>L~C</scope><scope>L~D</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9112-2705</orcidid></search><sort><creationdate>20220401</creationdate><title>Effects of Varying Levels of Inspiratory Assistance with Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist on Driving Pressure in Patients Recovering from Hypoxemic Respiratory Failure</title><author>Cammarota, Gianmaria ; Verdina, Federico ; De Vita, Nello ; Boniolo, Ester ; Tarquini, Riccardo ; Messina, Antonio ; Zanoni, Marta ; Navalesi, Paolo ; Vetrugno, Luigi ; Bignami, Elena ; Corte, Francesco Della ; De Robertis, Edoardo ; Santangelo, Erminio ; Vaschetto, Rosanna</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-3e2483d574532a9b2486f27036e448624b621a439a50a31900a7f6f559a028ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Anesthesiology</topic><topic>Critical Care Medicine</topic><topic>Cross-Over Studies</topic><topic>Health Sciences</topic><topic>Humans</topic><topic>Intensive</topic><topic>Intensive care</topic><topic>Interactive Ventilatory Support</topic><topic>Lung</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Original Research</topic><topic>Patients</topic><topic>Prospective Studies</topic><topic>Respiration</topic><topic>Respiratory failure</topic><topic>Respiratory Insufficiency - therapy</topic><topic>Statistical analysis</topic><topic>Statistics for Life Sciences</topic><topic>Ventilation</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cammarota, Gianmaria</creatorcontrib><creatorcontrib>Verdina, Federico</creatorcontrib><creatorcontrib>De Vita, Nello</creatorcontrib><creatorcontrib>Boniolo, Ester</creatorcontrib><creatorcontrib>Tarquini, Riccardo</creatorcontrib><creatorcontrib>Messina, Antonio</creatorcontrib><creatorcontrib>Zanoni, Marta</creatorcontrib><creatorcontrib>Navalesi, Paolo</creatorcontrib><creatorcontrib>Vetrugno, Luigi</creatorcontrib><creatorcontrib>Bignami, Elena</creatorcontrib><creatorcontrib>Corte, Francesco Della</creatorcontrib><creatorcontrib>De Robertis, Edoardo</creatorcontrib><creatorcontrib>Santangelo, Erminio</creatorcontrib><creatorcontrib>Vaschetto, Rosanna</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Computer and Information Systems Abstracts</collection><collection>Electronics & Communications Abstracts</collection><collection>Solid State and Superconductivity Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Computer Science Collection</collection><collection>Computer Science Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Advanced Technologies Database with Aerospace</collection><collection>Computer and Information Systems Abstracts Academic</collection><collection>Computer and Information Systems Abstracts Professional</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical monitoring and computing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cammarota, Gianmaria</au><au>Verdina, Federico</au><au>De Vita, Nello</au><au>Boniolo, Ester</au><au>Tarquini, Riccardo</au><au>Messina, Antonio</au><au>Zanoni, Marta</au><au>Navalesi, Paolo</au><au>Vetrugno, Luigi</au><au>Bignami, Elena</au><au>Corte, Francesco Della</au><au>De Robertis, Edoardo</au><au>Santangelo, Erminio</au><au>Vaschetto, Rosanna</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of Varying Levels of Inspiratory Assistance with Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist on Driving Pressure in Patients Recovering from Hypoxemic Respiratory Failure</atitle><jtitle>Journal of clinical monitoring and computing</jtitle><stitle>J Clin Monit Comput</stitle><addtitle>J Clin Monit Comput</addtitle><date>2022-04-01</date><risdate>2022</risdate><volume>36</volume><issue>2</issue><spage>419</spage><epage>427</epage><pages>419-427</pages><issn>1387-1307</issn><eissn>1573-2614</eissn><abstract>Background
Driving pressure can be readily measured during assisted modes of ventilation such as pressure support ventilation (PSV) and neurally adjusted ventilatory assist (NAVA). The present prospective randomized crossover study aimed to assess the changes in driving pressure in response to variations in the level of assistance delivered by PSV vs NAVA.
Methods
16 intubated adult patients, recovering from hypoxemic acute respiratory failure (ARF) and undergoing assisted ventilation, were randomly subjected to six 30-min-lasting trials. At baseline, PSV (PSV100) was set with the same regulation present at patient enrollment. The corresponding level of NAVA (NAVA100) was set to match the same inspiratory peak of airway pressure obtained in PSV100. Therefore, the level of assistance was reduced and increased by 50% in both ventilatory modes (PSV50, NAVA50; PSV150, NAVA150). At the end of each trial, driving pressure obtained in response to four short (2–3 s) end-expiratory and end-inspiratory occlusions was analyzed.
Results
Driving pressure at PSV50 (6.6 [6.1–7.8] cmH
2
O) was lower than that recorded at PSV100 (7.9 [7.2–9.1] cmH
2
O,
P
= 0.005) and PSV150 (9.9 [9.1–13.2] cmH
2
O,
P
< 0.0001). In NAVA, driving pressure at NAVA50 was reduced compared to NAVA150 (7.7 [5.1–8.1] cmH
2
O vs 8.3 [6.4–11.4] cmH
2
O,
P
= 0.013), whereas there were no changes between baseline and NAVA150 (8.5 [6.3–9.8] cmH
2
O vs 8.3 [6.4–11.4] cmH
2
O,
P
= 0.331, respectively). Driving pressure at PSV150 was higher than that observed in NAVA150 (
P
= 0.011).
Conclusions
NAVA delivers better lung-protective ventilation compared to PSV in hypoxemic ARF patients.
Trial registration number and date of registration
The present trial was prospectively registered at
www.clinicatrials.gov
(NCT03719365) on 24 October 2018</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>33559864</pmid><doi>10.1007/s10877-021-00668-2</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-9112-2705</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1387-1307 |
| ispartof | Journal of clinical monitoring and computing, 2022-04, Vol.36 (2), p.419-427 |
| issn | 1387-1307 1573-2614 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7871131 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Anesthesiology Critical Care Medicine Cross-Over Studies Health Sciences Humans Intensive Intensive care Interactive Ventilatory Support Lung Medicine Medicine & Public Health Mortality Original Research Patients Prospective Studies Respiration Respiratory failure Respiratory Insufficiency - therapy Statistical analysis Statistics for Life Sciences Ventilation Ventilators |
| title | Effects of Varying Levels of Inspiratory Assistance with Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist on Driving Pressure in Patients Recovering from Hypoxemic Respiratory Failure |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-11T16%3A19%3A12IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effects%20of%20Varying%20Levels%20of%20Inspiratory%20Assistance%20with%20Pressure%20Support%20Ventilation%20and%20Neurally%20Adjusted%20Ventilatory%20Assist%20on%20Driving%20Pressure%20in%20Patients%20Recovering%20from%20Hypoxemic%20Respiratory%20Failure&rft.jtitle=Journal%20of%20clinical%20monitoring%20and%20computing&rft.au=Cammarota,%20Gianmaria&rft.date=2022-04-01&rft.volume=36&rft.issue=2&rft.spage=419&rft.epage=427&rft.pages=419-427&rft.issn=1387-1307&rft.eissn=1573-2614&rft_id=info:doi/10.1007/s10877-021-00668-2&rft_dat=%3Cproquest_pubme%3E2487748876%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2667081783&rft_id=info:pmid/33559864&rfr_iscdi=true |