ArticleAnesthesiology2014
Clinical assessment of auto-positive end-expiratory pressure by diaphragmatic electrical activity during pressure support and neurally adjusted ventilatory assist.
Article in Anesthesiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 41 citations in OpenAlex.
- Neurally adjusted ventilatory assisted ventilation compared to pressure support during post-operative weaning of hepatic patients undergoing major abdominal surgeries: a randomized control trial.BMC anesthesiology · 2025Trial
- Neurally Adjusted Ventilatory Assist (NAVA) or Pressure Support Ventilation (PSV) during spontaneous breathing trials in critically ill patients: a crossover trial.BMC pulmonary medicine · 2017Trial
- Neural versus pneumatic control of pressure support in patients with chronic obstructive pulmonary diseases at different levels of positive end expiratory pressure: a physiological study.Critical care (London, England) · 2015Trial
- [A case of neonatal congenital myasthenic syndrome caused byZhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2026Article
- Inspiratory effort estimated by airway occlusion pressure in the presence of intrinsic positive end-expiratory pressure.Critical care (London, England) · 2026Article
- Diagnostic Insights from Plethysmographic Alveolar Pressure Assessed during Spontaneous Breathing in COPD Patients.Diagnostics (Basel, Switzerland) · 2021Review
- A brief airway occlusion is sufficient to measure the patient's inspiratory effort/electrical activity of the diaphragm index (PEI).Journal of clinical monitoring and computing · 2021Article
- Neurally adjusted ventilatory assist vs. pressure support to deliver protective mechanical ventilation in patients with acute respiratory distress syndrome: a randomized crossover trial.Annals of intensive care · 2020Article
- Continuous monitoring of intrinsic PEEP based on expired COCritical care (London, England) · 2019Article
- The Effects of Positive End-Expiratory Pressure on Transpulmonary Pressure and Recruitment-Derecruitment During Neurally Adjusted Ventilator Assist: A Continuous Computed Tomography Study in an Animal Model of Acute Respiratory Distress Syndrome.Frontiers in physiology · 2019Article
- Esophageal and transpulmonary pressure in the clinical setting: meaning, usefulness and perspectives.Intensive care medicine · 2016Review
- Neurally adjusted ventilatory assist.Current opinion in critical care · 2015Review
- Diaphragmatic electrical activity: a new tool to assess lung hyperinflation?Anesthesiology · 2014Article
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Authors and funding
8 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAuto-positive end-expiratory pressure (auto-PEEP) may substantially increase the inspiratory effort during assisted mechanical ventilation. Purpose of this study was to assess whether the electrical activity of the diaphragm (EAdi) signal can be reliably used to estimate auto-PEEP in patients undergoing pressure support ventilation and neurally adjusted ventilatory assist (NAVA) and whether NAVA was beneficial in comparison with pressure support ventilation in patients affected by auto-PEEP.
methodsIn 10 patients with a clinical suspicion of auto-PEEP, the authors simultaneously recorded EAdi, airway, esophageal pressure, and flow during pressure support and NAVA, whereas external PEEP was increased from 2 to 14 cm H2O. Tracings were analyzed to measure apparent "dynamic" auto-PEEP (decrease in esophageal pressure to generate inspiratory flow), auto-EAdi (EAdi value at the onset of inspiratory flow), and IDEAdi (inspiratory delay between the onset of EAdi and the inspiratory flow).
resultsThe pressure necessary to overcome auto-PEEP, auto-EAdi, and IDEAdi was significantly lower in NAVA as compared with pressure support ventilation, decreased with increase in external PEEP, although the effect of external PEEP was less pronounced in NAVA. Both auto-EAdi and IDEAdi were tightly correlated with auto-PEEP (r = 0.94 and r = 0.75, respectively). In the presence of auto-PEEP at lower external PEEP levels, NAVA was characterized by a characteristic shape of the airway pressure.
conclusionsIn patients with auto-PEEP, NAVA, compared with pressure support ventilation, led to a decrease in the pressure necessary to overcome auto-PEEP, which could be reliably monitored by the electrical activity of the diaphragm before inspiratory flow onset (auto-EAdi).
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