Assessment of patient-ventilator breath contribution during neurally adjusted ventilatory assist.

Intensive Care Medicine
Giacomo GrasselliChrister Sinderby

Abstract

During neurally adjusted ventilatory assist (NAVA), it is difficult to quantify the relative contribution of the patient versus the ventilator to the inspiratory tidal volume (Vt(insp)). To solve this problem, we developed an index, the "patient-ventilator breath contribution" (PVBC), using the inspiratory deflection of the diaphragmatic electrical activity (∆EAdi) and Vt(insp) during assisted and non-assisted breaths. This study evaluated the PVBC index in an experimental setup. Nine intubated and sedated rabbits were studied during repeated ramp increases of the NAVA level. One breath was non-assisted at each NAVA level. The PVBC index was evaluated during resistive loading and after acute lung injury. PVBC was calculated by relating Vt(insp)/∆EAdi of a non-assisted breath to that of the preceding assisted breath. The PVBC was compared to the relative contribution of esophageal pressure (∆Pes) to transpulmonary pressure deflections (∆P (L,dyn)). The relationship between PVBC and ∆Pes/∆P (L,dyn) was slightly curvilinear with an intercept different from zero (y = -1x (2 )+ 1.64x + 0.21) and a determination coefficient (R ...Continue Reading

Associated Clinical Trials

References

Feb 1, 1989·The American Review of Respiratory Disease·L BrochardF Lemaire
Aug 1, 1982·Respiration Physiology·F M Bennett, S M Tenney
Oct 24, 1997·Journal of Applied Physiology·A AlivertiS Yan
Feb 26, 1998·American Journal of Respiratory and Critical Care Medicine·J P VialeG Annat
Aug 4, 1998·Journal of Applied Physiology·J BeckA Grassino
Sep 8, 1998·Journal of Applied Physiology·J BeckA Grassino
Dec 8, 1998·Journal of Applied Physiology·C SinderbyA Grassino
Sep 3, 1999·American Journal of Respiratory and Critical Care Medicine·S G ZakynthinosG E Tzelepis
Dec 2, 1999·Nature Medicine·C SinderbyL Lindström
Aug 14, 2001·American Journal of Respiratory and Critical Care Medicine·J BeckC Sinderby
Aug 17, 2002·Journal of Applied Physiology·Robert L JohnsonRobb W Glenny
Nov 16, 2004·Journal of Applied Physiology·André De Troyer
Oct 3, 2008·The European Respiratory Journal·C J JolleyJ Moxham
May 12, 2009·Respiratory Physiology & Neurobiology·François LecomteChrister Sinderby
Aug 22, 2009·Journal of Applied Physiology·Kevin E Finucane, Bhajan Singh
Nov 26, 2009·Respiratory Physiology & Neurobiology·Edgardo D'AngeloMatteo Pecchiari
Jul 14, 2010·Respiratory Physiology & Neurobiology·Carlos B MantillaGary C Sieck
Aug 18, 2010·Annals of Internal Medicine·Martin J TobinAmal Jubran
Apr 5, 2011·Critical Care : the Official Journal of the Critical Care Forum·Samir JaberBasil J Petrof
Dec 1, 2011·Intensive Care Medicine·Nicolò PatronitiAntonio Pesenti

❮ Previous
Next ❯

Citations

Nov 19, 2013·Seminars in Fetal & Neonatal Medicine·Howard Stein, Kimberly Firestone
Jan 25, 2014·Critical Care : the Official Journal of the Critical Care Forum·Lucia MirabellaJennifer Beck
Apr 18, 2015·Critical Care : the Official Journal of the Critical Care Forum·Ling LiuHaibo Qiu
Dec 30, 2014·Current Opinion in Critical Care·Leo M A HeunksJohannes G van der Hoeven
Dec 14, 2012·Current Opinion in Critical Care·Ricardo Luiz CordioliLaurent Brochard
Apr 12, 2014·Current Opinion in Critical Care·Giacomo Bellani, Antonio Pesenti
Aug 12, 2020·Intensive Care Medicine·Annemijn H JonkmanLaurent J Brochard
Sep 29, 2018·Critical Care : the Official Journal of the Critical Care Forum·Diana JansenLeo M A Heunks
Jan 4, 2019·Annals of Intensive Care·Katerina VaporidiDimitris Georgopoulos
Dec 26, 2016·Respiratory Physiology & Neurobiology·Lukas BranderChrister Sinderby

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.