The impact of neurally adjusted ventilatory assist mode on respiratory severity score and energy expenditure in infants: a randomized crossover trial
The impact of neurally adjusted ventilatory assist mode on respiratory severity score and energy expenditure in infants: a randomized crossover trial
复制标题
DOI：
10.1038/jp.2017.154
复制
发表时间：
2018-01-01
影响因子：
2.9
通讯作者：
Manimtim, W. M.
中科院分区：
文献类型：
--
作者：
Rosterman, J. L.;Pallotto, E. K.;Manimtim, W. M.
目的：比较呼吸严重度评分(RSS)(平均气道压x吸氧分数)和静息能量消耗(REE)在神经调节辅助(NAVA)和压力控制和支持呼吸(SIMV(PC)PS)同步间歇指令呼吸机(SIMV(PC)PS)中的作用。24例患者分别用NAVA或SIMV(PC)PS机械通气12h，然后切换到替代模式12h，分析两种模式的一次呼吸结局(RSS)和其他二次呼吸结局。在NAVA上，吸气峰值压较低(17.8比19.9厘米H2O(P<；0.05))，而不需要较高的氧气需求。NAVA模式呼吸频率较高(52vs39(P<；0.05))，呼吸功(WOB)(0.01vs0.04J L(-1)，P<；0.05)得到改善。虽然呼吸频率较高，但这被NAVA期间较低的吸气峰值压力和WOB所抵消。
OBJECTIVE: Examine respiratory severity scores (RSS) (mean airway pressure x fraction of inspired oxygen) and resting energy expenditure (REE) on neurally adjusted ventilatory assist (NAVA) compared with synchronized intermittent mandatory ventilation with pressure controlled and supported breath (SIMV (PC) PS).STUDY DESIGN: A randomized, crossover trial in a level IV neonatal intensive care unit. Twenty-four patients were ventilated with NAVA or SIMV (PC) PS for 12 h and then crossed over to the alternative mode for 12 h. The primary outcome (RSS) and additional secondary respiratory outcomes were analyzed.RESULTS: RSS and measured REE were not different between modes. On NAVA, peak inspiratory pressures were lower (17.8 vs 19.9 cm H2O (P < 0.05)) without higher oxygen requirements. Respiratory rates were higher on NAVA (52 vs 39 (P < 0.05)), estimated work of breathing (WOB) (0.01 vs 0.04 J l(-1) (P < 0.05)) was improved.CONCLUSION: NAVA mode can be safe without increase in RSS or REE. Although respiratory rates were higher, this was offset by lower peak inspiratory pressures and WOB during NAVA.