Respiratory Failure Clinical Trial
Official title:
Performance of Neurally Adjusted Ventilatory Assist (NAVA) During an Spontaneous Breathing Trial
The purpose of this study is to compare a new mode of mechanical ventilation (NAVA, or Neurally adjusted Ventilatory assist) with a traditional mode (Pressure Support ventilation) on its the ability to detect patients ready for extubation (liberation from mechanical ventilation).
Patients under mechanical ventilation who are suspected to be recovered and ready to return
to spontaneous ventilation often undergo an spontaneous breathing trial (SBT) before
extubation and liberation from mechanical ventilation. During the test, which lasts from 30
minutes to 2 hours , the patient receives minimal support from the ventilator, and the ICU
team observes if the patient develops any signs or symptoms of discomfort or respiratory
distress. If the patient tolerates the test, he or she is considered ready for extubation.
The Neurally Adjusted Ventilatory Assist (NAVA) is a new mode of ventilation, shown to
improve patient-ventilator synchrony. It has not been tested during SBTs. Our objective is
to compare the performance of NAVA with the commonly used Pressure Support ventilation,
during an SBT. Patients considered to be ready for an SBT by the ICU team will undergo two
SBTs in random order: one in pressure support, and the other on NAVA, with a 1-hour interval
between the tests. Ventilatory parameters and patient-ventilator interaction variables will
be compared among the two tests.
This study will help us understand if NAVA can be used during an SBT, which might be
important for patients who are being ventilated with NAVA before the SBT is suggested,
especially those how present a high asynchrony rate when ventilated with Pressure Support
Mode.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Caregiver), Primary Purpose: Screening
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