Medicina neonatal y pediátrica

Abstracto

Comparison NAVA mode ventilation vs PSV & CPAP mode of ventilation / in children with neonatal RDS/

Uzunova D, Ignatov B. Eng

Background: The potential of NAVA is to adjust to the babies’ efforts for ventilation and reduce Ventilator Induced Diaphragm Dysfunction. [1] This action is based on the continuous coupling between the patient´s neural output and ventilator assistance. In contrast to Pressure Support ventilation, where a gradual increase in the assist level will abolish the electrical activity of the diaphragm, an increase in the NAVA level will unload the muscle but still maintain muscle activity.[2] Hence, over-assist by Pressure Support will function as a semi-controlled mode where the patient may be triggering the ventilator, by a small activation of the intercostal muscles resulting in a large tidal volume delivery. In contrast, NAVA will maintain the same tidal volume and physiologic diaphragm activation with the degree depending on the NAVA level set [3].

The standard modes include PSV and CPAP modes

Comparison of NAVA mode with standard respiratory support in children with neonatal RDS

Describe clinical characteristics, respiratory parameters and subjective signs of comfort during treatment in patients in the described two groups of ventilation in the neonatology department of the second Sheinovo Hospital- Sofia.

This is a prospective study of cases in the two groups described

Including Criteria: Ventilated patients in two groups, with a subject of detailed pathology and available to breathe spontaneously

The cases till now 22 cases were processed in two groups

Exceptions are ventilated patients with asphyxia, aspiration syndrome, and neurological signs

Comparison of:

NAVA invasive mode ^* PSV

NAVA non-invasive ventilation ^* CPAP

Report On The Quality Of Synchronization And Comfort

Synchronization with the apparatus- with the following signs hours of calmness and sleeping / without an alarm on the monitoring system/, the presence of tachydispnea. We use the Index of a synchronization - The asynchronous index [AI]. It is calculated as the number of cycles with a visible desynchronization /auto-triggering, insufficient spontaneous breathing, double triggering, short breathing cycle/ divided by the number of synchronized cycles, calculated at the rates per unit time according to the index of respiratory effort, calculated as the ratio of the Edi / TIn for each respiratory cycle during the observed 15-minute period the number of cases of reintubation or changing of the mode of ventilation

Materials and methods: Clinical experience in the Neonatology Department till May 2018

Conclusion: Registration of the advantages of the invasive NAVA mode at low gestational age and spontaneous respiration of more than 20%, exceptionally good effect on post- extubation patients in both modes of non-invasive ventilation, a clear advantage of full-term patients with extra alveolar gas collections from the non-invasive Nava mode during recovery.