Respiratory Insufficiency Clinical Trial
Official title:
FEASIBILITY OF 24 Hrs VENTILATION WITH NEURALLY ADJUSTED VENTILATORY ASSIST (NAVA) IN PATIENTS WITH ACUTE RESPIRATORY FAILURE
Neurally Adjusted Ventilatory Assist (NAVA) is a new mode of mechanical ventilation that is controlled by the electrical activity of the diaphragm (EAdi). The EAdi is a signal that represents the patient's breathing effort, and hence with NAVA, the assist being delivered is synchronized and proportional to the demands of the patient. This is a prospective physiological study of the feasibility of NAVA ventilation over 24 hours. The aim is to demonstrate that NAVA can maintain spontaneous breathing and unload the respiratory muscles during both sleep and wake cycles over a 24 hour period.
To date, studies using NAVA technology have been limited to short term evaluations (under 3
hours). No serious adverse events have been observed in patients enrolled in our 3-hour
study of NAVA in patients with acute lung injury. All 15 patients successfully tolerated the
period of ventilation (i.e. there were no dropouts) with NAVA and the stability of the blood
gas parameters over time reveals the efficiency of this new mode of ventilation in regards
to oxygenation.
A longer study may help to evaluate patient tolerance of NAVA and stability over time. A
longer study will also demonstrate the feasibility of NAVA to adapt to changes in
respiratory drive, changes in patient status, and the interventions of health care
providers. A longer time frame should help us understand the parameters for titration of
NAVA settings over time and establish some indications/limits for the future use of this
promising technique. This intermediate study will generate the data necessary for the
development of additional protocols to refine NAVA application and to compare NAVA to other
assist modes.
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Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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