Performance of NAVA as lung protective mechanical ventilation in patients with acute respiratory distress syndrome

• Grant number: 11/20225-1
• Support Opportunities: Regular Research Grants
• Start date: March 01, 2012
• End date: February 28, 2015
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Juliana Carvalho Ferreira
• Grantee: Juliana Carvalho Ferreira
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Associated researchers: Adriano Mesquita Alencar ; Carlos Roberto Ribeiro de Carvalho ; Fábia Diniz Silva ; Henrique Takachi Moriya ; Marcelo Britto Passos Amato

Abstract

NAVA (Neurally Adjusted ventilatory-Assist) is an assisted ventilatory mode that captures the electrical activity of the diaphragm and uses it to initiate and terminate the inspiratory phase, offering inspiratory assistance in proportion to patient effort, cycle by cycle. Studies in animals and humans have shown that NAVA reduces work of breathing and improves patient-ventilator interaction in comparison with traditional modes. Because it is an assisted mode, its use requires less sedation. The use of NAVA could contribute to the reduction of complications of prolonged mechanical ventilation in patients with Acute Respiratory Distress Syndrome (ARDS) submitted to protective ventilation with low tidal volumes and limited plateau pressure. However, there are no studies with NAVA in the acute phase of ARDS, in which assisted-controlled modes are generally used, allowing for adjustment of tidal volume and / or plateau pressure. In NAVA, neither the tidal volume nor peak pressure are predetermined and may vary in proportion to the patient's inspiratory effort. We don't know if NAVA can be adjusted to keep the tidal volume below 6 ml / kg of ideal weight and at levels comparable to those obtained in assist-controlled modes in patients with ARDS. With this project, we intend to evaluate the behavior of NAVA mode in the acute phase of mechanical ventilation in ARDS patients, to assess whether this mode can be used to deliver an assisted lung protective ventilation strategy. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

DINIZ-SILVA, FABIA; MORIYA, HENRIQUE T.; ALENCAR, ADRIANO M.; AMATO, MARCELO B. P.; CARVALHO, CARLOS R. R.; FERREIRA, JULIANA C.. Neurally adjusted ventilatory assist vs. pressure support to deliver protective mechanical ventilation in patients with acute respiratory distress syndrome: a randomized crossover trial. ANNALS OF INTENSIVE CARE, v. 10, n. 1, FEB 10 2020. (11/20225-1)

DINIZ-SILVA, FABIA; MIETHKE-MORAIS, ANNA; ALENCAR, ADRIANO M.; MORIYA, HENRIQUE T.; CARUSO, PEDRO; COSTA, EDUARDO L. V.; FERREIRA, JULIANA C.. Monitoring the electric activity of the diaphragm during noninvasive positive pressure ventilation: a case report. BMC PULMONARY MEDICINE, v. 17, p. 1-6, JUN 17 2017. (11/20225-1)

FERREIRA, JULIANA C.; DINIZ-SILVA, FABIA; MORIYA, HENRIQUE T.; ALENCAR, ADRIANO M.; AMATO, MARCELO B. P.; CARVALHO, CARLOS R. R.. Neurally Adjusted Ventilatory Assist (NAVA) or Pressure Support Ventilation (PSV) during spontaneous breathing trials in critically ill patients: a crossover trial. BMC PULMONARY MEDICINE, v. 17, NOV 7 2017. (11/20225-1)