Effects of neurally adjusted ventilatory assist on air distribution and dead space in patients with acute exacerbation of chronic obstructive pulmonary disease

Sun, Qiang; Liu, Ling; Pan, Chun; Zhao, Zhanqi; Xu, Jingyuan; Liu, Airan; Qiu, Haibo

doi:10.1186/s13054-017-1714-1

Cited by 20 publications

(14 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With help of EIT, they confirmed that ventilation was more homogeneously distributed during HFOV than during initial conventional mechanical ventilation. Sun et al [181] examined the air distribution in AECOPD patients with neurally adjusted ventilatory assist (NAVA). They found that ventilation distribution in dependent regions increased significantly during NAVA as compared to pressure support ventilation (PSV).…”

Section: Applications In Patients With Obstructive Lung Diseasesmentioning

confidence: 99%

A review of electrical impedance tomography in lung applications: Theory and algorithms for absolute images

Martins

Sato

Moura

et al. 2019

Annual Reviews in Control

Self Cite

View full text Add to dashboard Cite

Electrical Impedance Tomography (EIT) is under fast development, the present paper is a review of some procedures that are contributing to improve spatial resolution and material properties accuracy, admitivitty or impeditivity accuracy. A review of EIT medical applications is presented and they were classified into three broad categories: ARDS patients, obstructive lung diseases and perioperative patients. The use of absolute EIT image may enable the assessment of absolute lung volume, which may significantly improve the clinical acceptance of EIT. The Control Theory, the State Observers more specifically, have a developed theory that can be used for the design and operation of EIT devices. Electrode placement, current injection strategy and electrode electric potential measurements strategy should maximize the number of observable and controllable directions of the state vector space. A non-linear stochastic state observer, the Unscented Kalman Filter, is used directly for the reconstruction of absolute EIT images. Historically, difference images were explored first since they are more stable in the presence of modelling errors. Absolute images require more detailed models of contact impedance, stray capacitance and properly refined finite element mesh where the electric potential gradient is high. Parallelization of the forward *

show abstract

Section: Applications In Patients With Obstructive Lung Diseasesmentioning

confidence: 99%

A review of electrical impedance tomography in lung applications: Theory and algorithms for absolute images

Martins

Sato

Moura

et al. 2019

Annual Reviews in Control

Self Cite

View full text Add to dashboard Cite

show abstract

“…Our review showed that most studies using US to assess the diaphragm reported a reduction in diaphragm excursion in patients with COPD compared with healthy matched subject, and this reduction was correlated significantly with severity and prognosis. [13][14][15][16][17][18][19][20][21][22][23][24][25][26] The length of the diaphragm was also reported to be shortened in patients with COPD, where US-measured length was positively correlated with prognosis and negatively correlated with severity. 15 34 35 The result of this review agrees with previous findings where reduced diaphragmatic mobility measured by X-ray was linked with dynamic hyperinflation and air trapping in the lung of patients with COPD compared with healthy subjects.…”

Section: Discussionmentioning

confidence: 99%

“…Of the 35 studies assessing diaphragmatic changes in the COPD, 14 studies [13][14][15][16][17][18][19][20][21][22][23][24][25][26] reported a significant reduction in diaphragm excursion compared with healthy subjects as assessed by ultrasonography. However, Jain et al reported higher diaphragmatic movement in COPD as opposed to other studies.…”

Section: Us and Diaphragm Diaphragm Mobility And Lengthmentioning

confidence: 99%

Diagnostic and clinical values of non-cardiac ultrasound in COPD: A systematic review

et al. 2020

View full text Add to dashboard Cite

BackgroundClinical and research utility of non-cardiac ultrasound (US) in chronic obstructive pulmonary disease (COPD) has been widely investigated. However, there is no systematic review assessing the clinical values of non-cardiac US techniques in COPD.MethodsWe systematically searched electronic databases from inception to 24 June 2020. Two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines extracted data. A narrative synthesis of the results was conducted considering non-cardiac US techniques that looked for diaphragm, muscles and bones in patients with COPD.ResultsIn total, 2573 abstracts were screened, and 94 full-text papers were reviewed. A total of 54 studies met the inclusion criteria. Thirty-five studies assessed the diaphragm, while 19 studies evaluated different muscles, including limb muscles and pulmonary lesions in COPD using US. Of the 54 included studies, 30% (16/54) evaluated the changes in either limb muscles or diaphragmatic features before and after physical interventions; 67% (36/54) assessed the correlations between sonographic features and COPD severity. Indeed, 14/15 and 9/13 studies reported a significant reduction in diaphragm excursion and thickness in COPD compared with healthy subjects, respectively; this was correlated significantly with the severity and prognosis of COPD. Three studies reported links between diaphragm length and COPD, where lower diaphragm length correlated with poorer prognosis and outcomes. Quadriceps (rectus femoris), ankle dorsiflexor (tibialis anterior) and vastus lateralis were the most common muscles in COPD assessed by US. More than 70% (12/17) of the studies reported a significant reduction in the cross-sectional area (CSA) of the rectus femoris, rectus femoris and vastus lateralis thickness in COPD compared with healthy subjects. Quadriceps CSA and thickness correlated positively with COPD prognosis, in which patients with reduced quadriceps CSA and thickness have higher risk of exacerbation, readmission and death.ConclusionUS measurements of diaphragm excursion and thickness, as well as lower limb muscles strength, size and thickness, may provide a safe, portable and effective alternative to radiation-based techniques in diagnosis and prognosis as well as tracking improvement postintervention in patients with COPD.

show abstract

“…9,23 Several studies have described use of NAVA in subjects with COPD exacerbation. 11,14,[29][30][31][32][33] Among these, few studies have used NAVA while subjects were receiving either mechanical ventilation 29,30 or venovenous extracorporeal membrane oxygenation, 31 and reported the effects of NAVA on patient-ventilator interactions. However, other studies have compared NIV-NAVA to NIV-PSV in various patient populations.…”

Section: Discussionmentioning

confidence: 99%

Neurally-Adjusted Ventilatory Assist Versus Noninvasive Pressure Support Ventilation in COPD Exacerbation: The NAVA-NICE Trial

et al. 2019

View full text Add to dashboard Cite

BACKGROUND: This study was conducted to compare the effectiveness of noninvasive ventilation (NIV) with pressure support (NIV-PSV) to noninvasive neurally-adjusted ventilatory assist (NIV-NAVA) during COPD exacerbation. METHODS: In this study, 40 subjects with COPD and acute hypercapnic respiratory failure were randomized to receive either NIV-NAVA (n ‫؍‬ 20) or NIV-PSV (n ‫؍‬ 20) via a critical care ventilator. Subjects' vital parameters, arterial blood gas values, patient-ventilator asynchrony events, and asynchrony index were noted at specific time intervals in both groups. The duration of NIV, rate of NIV failure, and length hospital stay were also recorded for these 2 modes of NIV. RESULTS: NIV-NAVA significantly reduced the total number (median [interquartile range]) of asynchrony events compared to NIV-PSV: 22 (15-32.5) versus 65 (50.75-104.25), respectively, P ‫؍‬ .002. Severe asynchrony defined as asynchrony index > 10% was also significantly lower in NIV-NAVA than in NIV-PSV (P < .001). There was no significant difference between the 2 groups regarding improvement in gas exchange and vital parameters. Rate of failure of NIV (P ‫؍‬ .73), duration of the requirement of ventilatory support (P ‫؍‬ .40), and hospital length of stay (P ‫؍‬ .46) were also comparable between the 2 modes of ventilation. CONCLUSIONS: Compared to NIV-PSV, NIV-NAVA was associated with better patient-ventilator synchrony and a reduction in the number of asynchrony events in subjects with an exacerbation of COPD, with similar effects on improvement in gas exchange, duration of NIV, hospital lenght of stay, and rate of NIV failure. (Clinicaltrials.gov registration NCT02912689.

show abstract

Effects of neurally adjusted ventilatory assist on air distribution and dead space in patients with acute exacerbation of chronic obstructive pulmonary disease

Cited by 20 publications

References 22 publications

A review of electrical impedance tomography in lung applications: Theory and algorithms for absolute images

A review of electrical impedance tomography in lung applications: Theory and algorithms for absolute images

Diagnostic and clinical values of non-cardiac ultrasound in COPD: A systematic review

Neurally-Adjusted Ventilatory Assist Versus Noninvasive Pressure Support Ventilation in COPD Exacerbation: The NAVA-NICE Trial

Contact Info

Product

Resources

About