Respiration, Artificial Clinical Trial
Official title:
Patient-ventilator Asynchrony During Mechanical Invasive Assisted-ventilation in Pediatric Patients
The purpose of this study is to document the prevalence and type of asynchronies incidence
during invasive mechanical ventilation in pediatric patients breathing under pressure
support.
And to observe the impact of adjusting the expiratory trigger setting on asynchronies, and
compare these incidences with asynchronies measured in pediatric patient breathing under
NAVA system (Neurally Adjusted Ventilatory Assist).
Two sessions will be recorded, one in PSV, one with NAVA, delivered in a random order after
being sure the infant is calm and comfortable, according to his parents and/or the nurse in
charge.
Criteria for initiating invasive ventilation and to start PSV will follow the usual practice
guidelines of the unit.
Ventilation parameters in PS will be adjusted by the clinician in charge of the patient, as
usual based on clinical observation. Investigators will not interfere with ventilator
settings. Ventilation will be applied via an endotracheal tube, uncuffed for the majority
(if infant < 5 years), according to commonly applied guidelines in this unit.
One 15 minutes session will be recorded, after being sure the infant is calm and comfortable
according to the parents and/or the nurse in charge. Then the clinician in charge of the
patient will modify the ETS, first decreasing it of 10% below the initial set value, and
will be recorded the following 5 minutes after stabilization and secondly increasing it of
10% above the initial set value, and will be recorded the following 5 minutes after
stabilization.
NAVA will be set to deliver initially the same peak pressure (comparable level of assist)
than during the initial PS period. Same PEEP will be delivered in both modes. This is
possible with a pre-visualization window, allowing adjustments before switching to the NAVA
mode. Nava ventilation will be recorded during 20 minutes.
The 2 sessions, Pressure support and Nava, will be recorded consecutively.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Basic Science
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