scholarly journals Neurally adjusted ventilatory assist decreases work of breathing during non-invasive ventilation in infants with severe bronchiolitis

Critical Care ◽  
2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Florent Baudin ◽  
Guillaume Emeriaud ◽  
Sandrine Essouri ◽  
Jennifer Beck ◽  
Etienne Javouhey ◽  
...  
Keyword(s):  
Work Of Breathing ◽  
Neurally Adjusted Ventilatory Assist ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Ventilatory Assist

scholarly journals Neurally adjusted ventilatory assist (NAVA) improves patient–ventilator interaction during non-invasive ventilation delivered by face mask

2012 ◽  
Vol 38 (10) ◽  
pp. 1624-1631 ◽  
Author(s):  
Lise Piquilloud ◽  
Didier Tassaux ◽  
Emilie Bialais ◽  
Bernard Lambermont ◽  
Thierry Sottiaux ◽  
...  
Keyword(s):  
Face Mask ◽  
Neurally Adjusted Ventilatory Assist ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Ventilatory Assist

scholarly journals Short-term effects of synchronized vs. non-synchronized NIPPV in preterm infants: study protocol for an unmasked randomized crossover trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Francesco Cresi ◽  
Federica Chiale ◽  
Elena Maggiora ◽  
Silvia Maria Borgione ◽  
Mattia Ferroglio ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Work Of Breathing ◽  
Respiratory Rhythm ◽  
Assisted Ventilation ◽  
Positive Pressure ◽  
Invasive Ventilation ◽  
Short Term ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Short Term Effects

Abstract Background Non-invasive ventilation (NIV) has been recommended as the best respiratory support for preterm infants with respiratory distress syndrome (RDS). However, the best NIV technique to be used as first intention in RDS management has not yet been established. Nasal intermittent positive pressure ventilation (NIPPV) may be synchronized (SNIPPV) or non-synchronized to the infant’s breathing efforts. The aim of the study is to evaluate the short-term effects of SNIPPV vs. NIPPV on the cardiorespiratory events, trying to identify the best ventilation modality for preterm infants at their first approach to NIV ventilation support. Methods An unmasked randomized crossover study with three treatment phases was designed. All newborn infants < 32 weeks of gestational age with RDS needing NIV ventilation as first intention or after extubation will be consecutively enrolled in the study and randomized to the NIPPV or SNIPPV arm. After stabilization, enrolled patients will be alternatively ventilated with two different techniques for two time frames of 4 h each. NIPPV and SNIPPV will be administered with the same ventilator and the same interface, maintaining continuous assisted ventilation without patient discomfort. During the whole duration of the study, the patient’s cardiorespiratory data and data from the ventilator will be simultaneously recorded using a polygraph connected to a computer. The primary outcome is the frequency of episodes of oxygen desaturation. Secondary outcomes are the number of the cardiorespiratory events, FiO2 necessity, newborn pain score evaluation, synchronization index, and thoracoabdominal asynchrony. The calculated sample size was of 30 patients. Discussion It is known that NIPPV produces a percentage of ineffective acts due to asynchronies between the ventilator and the infant’s breaths. On the other hand, an ineffective synchronization could increase work of breathing. Our hypothesis is that an efficient synchronization could reduce the respiratory work and increase the volume per minute exchanged without interfering with the natural respiratory rhythm of the patient with RDS. The results of this study will allow us to evaluate the effectiveness of the synchronization, demonstrating whether SNIPPV is the most effective non-invasive ventilation mode in preterm infants with RDS at their first approach to NIV ventilation. Trial registration ClinicalTrials.gov NCT03289936. Registered on September 21, 2017.

scholarly journals Randomised cross-over trial evaluating the short-term effects of non-invasive ventilation as an adjunct to airway clearance techniques in adults with cystic fibrosis

2019 ◽  
Vol 6 (1) ◽  
pp. e000399 ◽  
Author(s):  
Gemma Stanford ◽  
Helen Parrott ◽  
Diana Bilton ◽  
Penny Agent ◽  
Winston Banya ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Work Of Breathing ◽  
Evidence Base ◽  
Forced Expiratory Volume ◽  
Post Treatment ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Airway Clearance ◽  
Non Invasive Ventilation ◽  
Pre Treatment

IntroductionNon-invasive ventilation (NIV) is used in cystic fibrosis (CF) to support airway clearance techniques (ACTs) by augmenting tidal volumes and reducing patient effort. However, the evidence base for this is limited. We hypothesised that NIV, in addition to usual ACT, would increase sputum clearance. In addition, we investigated ease of sputum clearance (EoC), work of breathing (WoB) and NIV tolerability.MethodsAdults with CF (16+ years) at the end of hospitalisation for a pulmonary exacerbation were randomised to a cross-over trial of NIV-supported ACT or ACT alone in two consecutive days. No other changes to standard care were made. The primary outcome was the total 24-hour expectorated sputum wet weight after the intervention. Spirometry was completed pre-treatment and post-treatment. Oxygen saturations were measured pre-treatment, during treatment and post-treatment. EoC and WoB were assessed using Visual Analogue Scale.Results14 subjects completed the study (7 male, mean age 35 [SD 17] years, mean forced expiratory volume in 1 s [FEV1] 49 [20] % predicted). The difference between treatment regimens was −0.98 g sputum (95% CI −11.5 to 9.6, p=0.84) over 24 hours. During treatment oxygen saturations were significantly higher with NIV-supported ACT (mean difference 2.0, 95% CI 0.9 to 2.6, p=0.0004). No other significant differences were found in post-treatment FEV1, EoC, WoB, oxygen saturations or subject preference.ConclusionsThere was no difference in treatment effect between NIV-supported ACT and ACT alone, although the study was underpowered. Oxygen saturations were significantly higher during NIV-supported ACT, but with no effect on post-treatment saturations. NIV was well tolerated.Trial registration numberNCT01885650.

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