ArticleCritical care (London, England)2014
Automated patient-ventilator interaction analysis during neurally adjusted non-invasive ventilation and pressure support ventilation in chronic obstructive pulmonary disease.
Article in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Monitoring the patient-ventilator asynchrony during non-invasive ventilation.Frontiers in medicine · 2022Pooled it
- Neurally Adjusted Ventilatory Assist vs. Conventional Mechanical Ventilation in Adults and Children With Acute Respiratory Failure: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2022Pooled it
- The role of non-invasive ventilation used immediately after planned extubation for adults with chronic respiratory disorders.Saudi medical journal · 2018Pooled it
- New setting of neurally adjusted ventilatory assist for noninvasive ventilation by facial mask: a physiologic study.Critical care (London, England) · 2017Trial
- A diaphragmatic electrical activity-based optimization strategy during pressure support ventilation improves synchronization but does not impact work of breathing.Critical care (London, England) · 2017Trial
- A randomized clinical trial of neurally adjusted ventilatory assist versus conventional weaning mode in patients with COPD and prolonged mechanical ventilation.International journal of chronic obstructive pulmonary disease · 2016Trial
- Automatic Detection of Onset and Offset of Respiratory Electromyographic Activity in Severe COPD Patients on Non-Invasive Mechanical Ventilation.IEEE journal of translational engineering in health and medicine · 2026Article
- Application of neurally adjusted ventilatory assist (NAVA): a narrative review.Journal of thoracic disease · 2025Review
- Clinical review of non-invasive ventilation.The European respiratory journal · 2024Review
- Patient-Ventilator Synchronization During Non-invasive Ventilation: A Pilot Study of an Automated Analysis System.Frontiers in medical technology · 2021Article
- How to ventilate obstructive and asthmatic patients.Intensive care medicine · 2020Review
- Recruitment pattern of the diaphragm and extradiaphragmatic inspiratory muscles in response to different levels of pressure support.Annals of intensive care · 2020Article
- Time-based capnography detects ineffective triggering in mechanically ventilated children.Critical care (London, England) · 2019Article
- Control of respiratory drive by extracorporeal COCritical care (London, England) · 2019Article
- Assessing breathing effort in mechanical ventilation: physiology and clinical implications.Annals of translational medicine · 2018Review
- How should we monitor patients with acute respiratory failure treated with noninvasive ventilation?European respiratory review : an official journal of the European Respiratory Society · 2018Review
- Patient-ventilator asynchrony during conventional mechanical ventilation in children.Annals of intensive care · 2017Article
- Efficacy of ventilator waveform observation for detection of patient-ventilator asynchrony during NIV: a multicentre study.ERJ open research · 2017Article
- Monitoring the electric activity of the diaphragm during noninvasive positive pressure ventilation: a case report.BMC pulmonary medicine · 2017Article
- Roles of neurally adjusted ventilatory assist in improving gas exchange in a severe acute respiratory distress syndrome patient after weaning from extracorporeal membrane oxygenation: a case report.Journal of intensive care · 2016Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDelivering synchronous assist during non-invasive ventilation (NIV) is challenging with flow- or pressure-controlled ventilators, especially in patients with chronic obstructive pulmonary disease (COPD). Neurally adjusted ventilatory assist (NAVA) uses diaphragm electrical activity (EAdi) to control the ventilator. We evaluated patient-ventilator interaction in patients with COPD during NIV with pressure support ventilation (PSV) and NAVA using a recently introduced automated analysis.
methodsTwelve COPD patients underwent three 30-minute trials: 1) PSV with dedicated NIV ventilator (NIV-PSVVision), 2) PSV with intensive care unit (ICU) ventilator (NIV-PSVServo-I), and 3) with NIV-NAVA. EAdi, flow, and airway pressure were recorded. Patient-ventilator interaction was evaluated by comparing airway pressure and EAdi waveforms with automated computer algorithms. The NeuroSync index was calculated as the percentage of timing errors between airway pressure and EAdi.
resultsThe NeuroSync index was higher (larger error) for NIV-PSVVision (24 (IQR 15 to 30) %) and NIV-PSVServo-I (21 (IQR 15 to 26) %) compared to NIV-NAVA (5 (IQR 4 to 7) %; P <0.001). Wasted efforts, trigger delays and cycling-off errors were less with NAVA (P <0.05 for all). The NeuroSync index and the number of wasted efforts were strongly correlated (r2 = 0.84), with a drastic increase in wasted efforts after timing errors reach 20%.
conclusionsIn COPD patients, non-invasive NAVA improves patient-ventilator interaction compared to PSV, delivered either by a dedicated or ICU ventilator. The automated analysis of patient-ventilator interaction allowed for an objective detection of patient-ventilator interaction during NIV. In addition, we found that progressive mismatch between neural effort and pneumatic timing is associated with wasted efforts.
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