Performance of NAVA as lung protective mechanical ventilation in patients with Acute Respiratory Distress Syndrome

• Grant number: 12/01713-8
• Support Opportunities: Scholarships in Brazil - Doctorate
• Start date: December 01, 2012
• End date: March 31, 2017
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Juliana Carvalho Ferreira
• Grantee: Fábia Diniz Silva
• 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

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 workof 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 nostudies 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 obtainedin 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.

Academic Publications

(References retrieved automatically from State of São Paulo Research Institutions)

SILVA, Fábia Diniz. Comparison between Neurally Adjusted Ventilatory Assist and Pressure Support Ventilation to deliver protective ventilation in patients with acute respiratory distress syndrome. 2017. Doctoral Thesis - Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) São Paulo.