[Effect of neurally adjusted ventilatory assist on trigger of mechanical ventilation in acute exacerbation of chronic obstructive pulmonary disease patients with intrinsic positive end-expiratory pressure].
Zhonghua nei ke za zhi(2019)
Abstract
Objective: To compare the trigger delay and work of trigger between neurally adjusted ventilatory assist (NAVA) and pressure support ventilation (PSV) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with intrinsic positive end-expiratory pressure (PEEP) during mechanical ventilation. Methods: AECOPD patients with intrinsic PEEP (PEEPi) greater than or equal to 3 cmH(2)O (1 cmH(2)O=0.098 kPa) were enrolled during invasive mechanical ventilation. Subjects were ventilated with low, medium and high pressure under either NAVA or PSV mode. Servo Tracker software continuously recorded the waveform of ventilator and respiratory mechanics indexes (including respiratory frequency, inspiratory tidal volume (Vti), minute ventilation volume (VE), peak airway pressure (PIP), inspiratory time), and calculated trigger and expiratory conversion delay time, work of trigger and total work of breath. Results: A total of 14 AECOPD patients were enrolled with the average PEEPi (4.3±1.3) cmH(2)O. PSV inspiratory trigger delay time was positively correlated with PEEPi (r=0.913, P<0.05). Compared with PSV, NAVA significantly decreased trigger delay time in low, medium and high pressure level groups [(48±17) ms vs. (167±86) ms, (63±65) ms vs. (247±240) ms, (63±49) ms vs. (342±192) ms,respectively all P<0.05]. Similar results were shown as to work of trigger [(0.92±0.36) μV∙s vs. (1.22±0.70) μV∙s, (1.08±0.51) μV∙s vs. (1.62±1.25) μV∙s, (1.20±0.96) μV∙s vs. (2.29±1.02) μV∙s, all P<0.05]. Trigger delay time increased according to the increase of pressure level in PSV mode. Conclusion: The presence of PEEPi in AECOPD patients leads to obvious trigger delay under PSV mode, which is positively correlated with PEEPi level. NAVA significantly reduces trigger delay time and work of trigger compared with PSV mode.
MoreTranslated text
Key words
Acute exacerbation of chronic obstructive pulmonary disease,Intrinsic positive end-expiratory pressure,Neurally adjusted ventilatory assist,Pressure support ventilation,Trigger delay,Work of trigger
AI Read Science
Must-Reading Tree
Example
Generate MRT to find the research sequence of this paper
Chat Paper
Summary is being generated by the instructions you defined