Neonatology

Original Paper

Free Access

Neurally Adjusted Ventilatory Assist and Pressure Support Ventilation in Small Species and the Impact of Instrumental Dead Space

Campoccia Jalde F.a · Almadhoob A.R.b · Beck J.c–e · Slutsky A.S.e, f · Dunn M.S.c, d · Sinderby C.e, f

Author affiliations

aDepartment of Anaesthesiology and Intensive Care, Karolinska Hospital and Institute, Stockholm, Sweden; bUniversity of Toronto Neonatal-Perinatal Integrated Fellowship Program, cWomen and Babies Program, Sunnybrook Health Sciences Centre, dDepartment of Pediatrics, University of Toronto, eDepartment of Critical Care Medicine, Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, and fDepartment of Medicine, University of Toronto, Toronto, Ont., Canada

Corresponding Author

Jennifer Beck, PhD

Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael’s Hospital

30 Bond Street, Queen Wing 4-072

Toronto, ON M5B 1W8 (Canada)

Tel. +1 416 880 3664, Fax +1 416 760 7518, E-Mail beckj@smh.toronto.on.ca

Keywords: Neurally adjusted ventilatory assistPressure support ventilationDiaphragm electrical activityInstrumental dead space

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https://doi.org/10.1159/000255167

Abstract

Background: Neurally adjusted ventilatory assist (NAVA) is a pneumatically-independent mode of mechanical ventilation controlled by diaphragm electrical activity (EAdi), and has not yet been implemented in very small species. Objectives: The aims of the study were to evaluate the feasibility of applying NAVA in very small species and to compare this to pressure support ventilation (PSV) in terms of ventilatory efficiency and breathing pattern, and evaluate the impact of instrumental dead space on breathing pattern during both modes. Methods: Nine healthy rats (mean weight 385 ± 4 g) were studied while breathing on PSV or NAVA, at baseline or with added dead space. Results: A clear difference in breathing pattern between NAVA and PSV was observed during both baseline and dead space, where PSV – despite similar EAdi and tidal volume as during NAVA – caused shortened inspiratory time (p < 0.05) and increased the respiratory rate (p < 0.05). A higher minute ventilation (p < 0.05) in order to reach the same arterial CO2 was observed. Ineffective inspiratory efforts occurred only during PSV and decreased with the dead space. Conclusion: This study demonstrates, in a small group of animals, that NAVA can deliver assist in very small species with a higher efficiency than PSV in terms of eliminating CO2 for a given minute ventilation.

© 2009 S. Karger AG, Basel



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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 03, 2009
Accepted: May 18, 2009
Published online: November 04, 2009
Issue release date: March 2010

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 1

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: https://www.karger.com/NEO

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2010, Vol.97, No. 3

March 2010

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