Effect of Ventilatory Variability on Occurrence of Central Apneas

Delisle, Stéphane; Terzi, Nicolas; Ouellet, Paul; Bellemare, Patrick; Tétrault, Jean-Pierre; Arsenault, Pierre

doi:10.4187/respcare.01456

Cited by 9 publications

(16 citation statements)

References 55 publications

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“…The absence of desaturation during neural apneas is likely attributable to the backup ventilatory rate. The lack of neural apneas during NAVA is consistent with previous studies on adult patients [21]. Interpreting this finding, however, is not easy at all.…”

Section: Discussionsupporting

confidence: 81%

Neurally Adjusted Ventilatory Assist in Preterm Neonates with Acute Respiratory Failure

Longhini¹,

Ferrero

Luca

et al. 2014

Neonatology

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Background: Neurally adjusted ventilatory assist (NAVA) is a novel mode of ventilation that has been demonstrated to improve infant-ventilator interaction, compared to the conventional modes in retrospective and short-term studies. Objectives: To prospectively evaluate the physiologic effects of NAVA in comparison with pressure-regulated volume control (PRVC) in two nonrandomized 12-hour periods. Methods: We studied 14 consecutive intubated preterm neonates receiving mechanical ventilation for acute respiratory failure. Peak airway pressure (Paw_peak), diaphragm electrical activity (EAdi), tidal volume (V_T), mechanical (RR_mec) and neural (RR_neu) respiratory rates, neural apneas, and the capillary arterialized blood gases were measured. The RR_mec-to-RR_neu ratio (MNR) and the asynchrony index were also calculated. The amount of fentanyl administered was recorded. Results: Paw_peak and V_T were greater in PRVC (p < 0.01). Blood gases and RR_mec were not different between modes, while RR_neu and the EAdi swings were greater in NAVA (p = 0.02 and p < 0.001, respectively). MNR and the asynchrony index were remarkably lower in NAVA than in PRVC (p = 0.03 and p < 0.001, respectively). 1,841 neural apneas were observed during PRVC, with none in NAVA. Less fentanyl was administered during NAVA, as opposed to PRVC (p < 0.01). Conclusions: In acutely ill preterm neonates, NAVA can be safely and efficiently applied for 12 consecutive hours. Compared to PRVC, NAVA is well tolerated with fewer sedatives.

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Section: Discussionsupporting

confidence: 81%

Neurally Adjusted Ventilatory Assist in Preterm Neonates with Acute Respiratory Failure

Longhini¹,

Ferrero

Luca

et al. 2014

Neonatology

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“…6,8 Delisle et al, in this issue of RESPIRATORY CARE, report results of their study examining any association between the occurrence of central apneas during weaning and the application of NAVA or pressure support ventilation. 9 NAVA triggering was applied when the EAdi reached 0.5 V, and the EAdi signal was measured every 16 ms, both of which are consistent with the application of NAVA in other literature. 6,8 Delisle et al have identified a statistically significant increase in tidal volume variability when supported breaths were flow assisted by NAVA, a finding that is consistent with the conclusions of other recent publications.…”

supporting

confidence: 78%

Neurally Adjusted Ventilatory Assist: Insufficient Evidence of Broad Clinical Outcomes

Moss

2013

Respir Care

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“…This is a reply to the editorial by Moss 1 on the study by Delisle et al, 2 entitled "Effect of Ventilatory Variability on Occurrence of Central Apneas." In their prospective crossover study, Delisle et al 2 compared neurally adjusted ventilatory assist (NAVA) and pressure support ventilation in intubated adult patients during sleep and wakefulness.…”

Section: To the Editormentioning

confidence: 90%

“…Responding to my editorial 1 that accompanied the research by Delisle et al, 2 Sinderby raises 3 main questions. First, Sinderby asks why I summarize the outcome of the study with: "What is the clinical importance of this study; the 'So what?'…”

Section: Neurally Adjusted Ventilatory Assist: Insufficient Evidence mentioning

confidence: 99%

Neurally Adjusted Ventilatory Assist: Insufficient Evidence of Broad Clinical Outcomes

Sinderby

2013

Respir Care

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Effect of Ventilatory Variability on Occurrence of Central Apneas

Cited by 9 publications

References 55 publications

Neurally Adjusted Ventilatory Assist in Preterm Neonates with Acute Respiratory Failure

Neurally Adjusted Ventilatory Assist in Preterm Neonates with Acute Respiratory Failure

Neurally Adjusted Ventilatory Assist: Insufficient Evidence of Broad Clinical Outcomes

Neurally Adjusted Ventilatory Assist: Insufficient Evidence of Broad Clinical Outcomes

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