Comparing Noninvasive Ventilation Delivered Using Neurally-Adjusted Ventilatory Assist or Pressure Support in Acute Respiratory Failure.
Respir Care
; 66(2): 213-220, 2021 Feb.
Article
em En
| MEDLINE
| ID: mdl-32873750
ABSTRACT
BACKGROUND:
The use of neurally-adjusted ventilatory assist (NAVA) during noninvasive ventilation (NIV) results in better patient-ventilator interaction. Whether this improves clinical outcomes lacks dedicated study.METHODS:
In this randomized controlled trial, we compared NAVA with PSV for delivering NIV in consecutive subjects with de novo acute respiratory failure. The primary outcomes were NIV failure rates and 28-d mortality. The secondary outcomes were asynchrony index, NIV-related complications, and others.RESULTS:
We enrolled 100 subjects (50 subjects each for NAVA and PSV, 60% male) with a mean ± SD age of 56.7 ± 12 y. There was no difference in NIV failure rates (30% vs 32%, P = .83) and 28-d mortality rates (18% vs 34%, P = .07) between the NAVA and PSV arms, respectively. The median asynchrony index was significantly lower with NAVA (6.7 vs 44.8, P < .001). The use of NAVA significantly reduced NIV-related complications (32% vs 58%, P = .01). In a post hoc analysis, the use of NAVA significantly reduced the 28-d mortality in subjects with COPD exacerbation.CONCLUSIONS:
The use of NAVA during NIV did not improve NIV failure rate or 28-d mortality in subjects with acute respiratory failure. However, patient-ventilator asynchrony and NIV-related complications were reduced with NAVA. TRIAL REGISTRY www.clinicaltrials.gov (NCT03271671).Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Insuficiência Respiratória
/
Suporte Ventilatório Interativo
/
Ventilação não Invasiva
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article