NAVASET: Nava Level Titration Using Comfort Scales

University Hospital, Caen15 enrolled

Overview

Determining the optimal Neurally Adjusted Ventilatory Assist (NAVA) level remains challenging, and several methods have been suggested. However none of them seems easily utilisable. Thus the investigators propose to test a way of NAVA level titration according to ventilator comfort.

Physiological comparison of different levels of ventilator assistance during Neurally Adjusted Ventilatory Assist (NAVA) to evaluate the effect of these on tidal volume, inspiratoy activity, comfort scales. We propose to evaluate the ability to guide the titration according the patient's comfort scale. The intensity of the breathing sensations will be evaluated using the labeled visual analog scale (Banzett Scale).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

NONE

Enrollment

Conditions

Acute Respiratory Failure

Interventions

PSV - pressure support ventilationDEVICE

Gold standard partial ventilator support: Pressure Support Ventilation performed with Servo-i® ventilator (MAQUET,Critical Care, Sweden). Pressure support ventilator assistance to obtain a tidal volume of 6-8 ml/kg of ideal body weight.

Neurally Adjusted Ventilatory AssistDEVICE

Partial ventilator support partial ventilation mode (NAVA) performed with Servo-i® ventilator (Maquet,Critical Care, Sweden). Different levels of neurally adjusted ventilatory assist are tested. Stepwise implementation of the NAVA level (steps of 25% ), returning to the " optimal " level between each evaluation (PSV 100%, NAVA 100%, 75%, 50%, 125%, 150%).

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age \> 18 years * Hospitalized in intensive care unit for an acute respiratory failure * Intubated or tracheotomized and mechanically ventilated * RASS score: 0;-2 * Weaning period Exclusion Criteria: * Hemodynamic instability * Absence of consent * Contraindication of nasogastric catheter insertion

Locations (1)

CHU de Caen

Caen, France

RECRUITING

Outcomes

Primary Outcomes

Comparison of ventilatory comfort with the physiological parameters when varying the levels of pressure support and Neurally Adjusted Ventilatory Assist (NAVA)

To prove the feasibility of neurally adjusted ventilatory assist (NAVA) level titration according to the ventilatory comfort felt by the patient. The ventilatory comfort will be evaluated using the labeled visual analog scale (Banzett scale).

Time frame: 24hr

Secondary Outcomes

Efficiency

The efficiency will be evaluated by using minute ventilation

Time frame: 24hr

Efficiency

The efficiency will be evaluated using arterial PCO2.

Time frame: 24hr

Data from ClinicalTrials.gov

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