Health economic modeling of the potential cost saving effects of Neurally Adjusted Ventilator Assist

Abstract

This study showed economically favorable results for NAVA versus PSV. Our results show that only a minor decrease in the proportion of asynchronous patients with NAVA is needed for investments to pay off and generate savings. Future studies need to confirm this result by directly relating improved synchrony to the number of days on MV.

Neurally adjusted ventilatory assist versus conventional ventilation in the pediatric population: Are there benefits?

“…Such a trial would be based on the assumptions above that improved patient‐ventilation interaction leads to decreased used of sedation and then into decreased number of mechanical ventilation days and decreased the length of intensive care unit days. Hjelmgren et al suspected this would hold true and developed a decision analytical model that associated the state of synchrony/asynchrony with a specified duration of mechanical ventilation days and a corresponding daily cost in the intensive care unit. They concluded that a minor decrease in the proportion of asynchrony in intensive care unit patients with NAVA would result in a decrease in mechanical ventilation days and result in cost savings.…”

“…They concluded that a minor decrease in the proportion of asynchrony in intensive care unit patients with NAVA would result in a decrease in mechanical ventilation days and result in cost savings. Hjelmgren et al utilized data from previous clinical studies as well as a Swedish intensive care registry for their cost modeling.…”

“…Such a trial would be based on the assumptions above that improved patientventilation interaction leads to decreased used of sedation and then into decreased number of mechanical ventilation days and decreased the length of intensive care unit days. Hjelmgren et al 19 The meta-analyses included in this study are benefitted by the larger number of patients found in some of the endpoints. The metaanalyses are not without their limitations as well, however.…”

“…suspected this would hold true and developed a decision analytical model that associated the state of synchrony/asynchrony with a specified duration of mechanical ventilation days and a corresponding daily cost in the intensive care unit.They concluded that a minor decrease in the proportion of asynchrony in intensive care unit patients with NAVA would result in a decrease in mechanical ventilation days and result in cost savings. Hjelmgren et al19 utilized data from previous clinical studies as well as a Swedish intensive care registry for their cost modeling. Forest plot demonstrating pooled results for oxygen saturation [Color figure can be viewed at wileyonlinelibrary.com] of oxygen, partial pressure of carbon dioxide, total sedation requirement, duration of mechanical ventilation, duration of intensive care unit stay, and duration of hospital stay.…”

Evaluating the Cost-Effectiveness of Proportional-Assist Ventilation Plus vs. Pressure Support Ventilation in the Intensive Care Unit in Two Countries

“…This is beyond the realms of feasibility, and so model outputs are compared with previously reported values. In 2015, Hjelmgren et al considered the cost consequence of neutrally-adjusted ventilatory assist (NAVA) mechanical ventilation relative to PSV in the Swedish setting ( 39 ). Their model varied substantially from that presented here, not considering future healthcare costs or any items outside of the ICU.…”