Ventilator Lung
Conditions
Keywords
EIT. NAVA. Endexpiratory Lung Impedance.
Brief summary
The study compares two different ventilation modes, Pressure support ventilation vs. Neuronally Adjusted Ventilatory Assist, in postcardiac surgery patients. Of special interest is shunt and alveolar deadspace and ventral vs. dorsal ventilation.
Detailed description
The aim of the study is to compare two different ventilation modes in complicated postcardiac surgery patients, who need ventilatory support during weaning phase, in the Cardiothoracic Intensive Care Unit. The two different ventilation modes are Neuronally Adjusted Ventilatory Assist (NAVA) and Pressure Support ventilation. NAVA ventilation mode have been introduced a couple of years ago as an alternative to pressure support. The advantage of NAVA mode compared to pressure support is a better synchrony between patient and ventilator in the inspired and expired phases. Maybe there are also physiological advantages of the NAVA mode, which we want to study in the present study. All patients have three measurement periods. 1) Pressure support during 20 min, NAVA equilibration period of 30 min, followed by 2) NAVA ventilation for 20 min, pressure support equilibration period of 30 min and 3) pressure support for 20 min. Blood gases and cardiac output measurements is performed before and after each measurement period. Regional ventilation is measured by Electric Impedance Tomography (EIT).
Interventions
DEVICENAVA
Neurally Adjusted Ventilatory Assist is a fairly new ventilation mode
Sponsors
Sahlgrenska University Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Masking description
The investigator works as physician at the Department of Intensive Care. The participants are patients.
Intervention model description
Control-Intervention-Control
Eligibility
Sex/Gender
ALL
Age
18 Years to 84 Years
Healthy volunteers
No
Inclusion criteria
* Complicated Post Cardiac surgery patients in the ventilator weaning phase. * Patients requiring assisted ventilation * Respiratory and circulatory stable patients * Sedated patients, RASS -2 to -3
Exclusion criteria
* Transplanted patients * Pleural effusion.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ventilation distribution | Through study completion, within approximately 18 months | Redistribution of ventilation , dorsally vs. ventrally |
| Alveolar dead space | Through study completion, within approximately 18 months | Calculated from blood gases and end tidal pCO2,using standard formulae |
| End expiratory lung impedance | Through study completion, within approximately 18 months | Measured by Electric Impedance Tomography |
| PaO2/FiO2 | Through study completion, within approximately 18 months | Arterial oxygenation |
| Alveolar shunt | Through study completion, within approximately 18 months | Calculated from mixed venous and arterial blood gases |
Countries
Sweden
Outcome results
None listed