Marika Rahtu, Inéz Frerichs, Tobias H Becher, Tytti Pokka, Andreas D Waldmann, Thalia Papadouri, Anton H van Kaam, Peter C Rimensberger, Richard Bayford, Outi Peltoniemi, Merja Kallio
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引用次数: 0
Abstract
Introduction: Neurally Adjusted Ventilatory Assist (NAVA) is increasingly used as ventilatory support for preterm infants. Changes in ventilation distribution and respiratory patterns during the transition from patient-triggered time-cycled Pressure Controlled Ventilation (PCV) to NAVA have not yet been studied. This study aimed to evaluate the impact of ventilation mode (PCV and NAVA, respectively) on ventilation distribution and breathing patterns in preterm infants with Electrical Impedance Tomography.
Methods: This study included 16 premature infants at Oulu University Hospital who participated in the observational CRADL project and were on NAVA. EIT data was retrospectively assessed by choosing a 1-min stable recording before and after the change from one to the other mode. The primary endpoint was changes in global and regional ventilation parameters (ΔZ), and the secondary endpoints were Centers of Ventilation (CoVs), the amount of silent spaces, and the duration of inspiratory and respiratory cycle times.
Results: A larger variation in the global tidal impedance variation (p < 0.05) and the respiratory cycle time (p < 0.05) was observed on NAVA than on PCV. Sighs, which were determined as a breath impedance change twice the size of an average breath on PCV, were more frequent during NAVA than PCV (5.1% vs 0.8%, respectively). Mean global or regional impedance variations or silent spaces did not differ between PCV and NAVA.
Conclusion: NAVA allowed more variable breathing patterns during invasive respiratory support than patient-triggered PCV. However, variability in the respiratory cycle did not lead to systematic changes in ventilation distribution or silent spaces.
期刊介绍：
Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases.
PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.
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