Ventilator-Induced Lung Injury Clinical Trial
Official title:
Physiological Response to Different Levels of Support in Lung Transplant Recipients Undergoing Neurally Adjusted Ventilatory Assist (NAVA)
Primary Graft Dysfunction (PGD) respresents the leading cause of mortality in early post-operative period of Lung Tranplantation (LTx). Protective ventilatory strategy could potentially reduce the risk of PGD in these patients. Neurally Adjusted Ventilatory Assist (NAVA) is an assisted ventilation mode that could allow to adopt this strategy. Aim of the study is to assess the feasibility of NAVA in the early post-LTx phase and to describe the breathing pattern and the physiological relationship between neural respiratory drive and different levels of ventilatory assist, in the absence of pulmonary vagal afferent feedback.
Lung transplantation (LTx) is an important treatment option for select patients with
end-stage pulmonary disease. Primary Graft Dysfunction (PGD) is the main cause of death; in
the early period following LTx a protective ventilatory strategy (tidal volume - Vt of 6
mL/Kg + Positive End Expiratory Pressure) could potentially reduce the risk of PGD in these
patients. Neurally Adjusted Ventilatory Assist (NAVA) is an assisted ventilation mode in
which neural inspiratory activity is monitored through the continuous recording of electrical
activity of the diaphragm (EAdi). Actually, Guidelines about the adoption of a protective
ventilatory strategy in the early post-opeartive period are lacking.
NAVA, because of its intrinsic properties (proportionality between respiratory drive and
level of assist, prevention of diaphragm atrophy), could allow to reach the afore mentioned
ventilatory strategy. So, aim of the study, is the evaluation of patients' neural breathing
pattern during NAVA, in early post-operative period of LTx
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