Neurally Adjusted Ventilatory Assist (NAVA) vs Pressure Support Ventilation After Cardiac Surgery

Study Overview
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Brief Summary
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The study compares two different ventilation modes, Pressure support ventilation vs. Neuronally Adjusted Ventilatory Assist, in postcardiac surgery patients. Of special interest is shunt and alveolar deadspace and ventral vs. dorsal ventilation.

Detailed Description
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The aim of the study is to compare two different ventilation modes in complicated postcardiac surgery patients, who need ventilatory support during weaning phase, in the Cardiothoracic Intensive Care Unit. The two different ventilation modes are Neuronally Adjusted Ventilatory Assist (NAVA) and Pressure Support ventilation. NAVA ventilation mode have been introduced a couple of years ago as an alternative to pressure support. The advantage of NAVA mode compared to pressure support is a better synchrony between patient and ventilator in the inspired and expired phases. Maybe there are also physiological advantages of the NAVA mode, which we want to study in the present study. All patients have three measurement periods. 1) Pressure support during 20 min, NAVA equilibration period of 30 min, followed by 2) NAVA ventilation for 20 min, pressure support equilibration period of 30 min and 3) pressure support for 20 min. Blood gases and cardiac output measurements is performed before and after each measurement period. Regional ventilation is measured by Electric Impedance Tomography (EIT).

Official Title
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NAVA vs Pressure Support After Cardiac Surgery, a Physiological Study

Conditions
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Ventilator Lung

Intervention / Treatment
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* Device: NAVA


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Complicated Post Cardiac surgery patients in the ventilator weaning phase. Patients requiring assisted ventilation Respiratory and circulatory stable patients Sedated patients, RASS -2 to -3 Exclusion Criteria: Transplanted patients Pleural effusion.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 84 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: Control-Intervention-Control
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: NAVA vs Pressure Support<br>Control (pressure support) - NAVA - Control (Pressure Support) Intervention is NAVA | Device: NAVA<br>* Neurally Adjusted Ventilatory Assist is a fairly new ventilation mode<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ventilation distribution | Redistribution of ventilation , dorsally vs. ventrally | Through study completion, within approximately 18 months | 
| Alveolar dead space | Calculated from blood gases and end tidal pCO2,using standard formulae | Through study completion, within approximately 18 months | 
| End expiratory lung impedance | Measured by Electric Impedance Tomography | Through study completion, within approximately 18 months | 
| PaO2/FiO2 | Arterial oxygenation | Through study completion, within approximately 18 months | 
| Alveolar shunt | Calculated from mixed venous and arterial blood gases | Through study completion, within approximately 18 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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EIT. NAVA. Endexpiratory Lung Impedance.