Longhini F, Liu L, Pan C, et al. Respir Care. 2019;64(5):582-589
In this study compared neurally-controlled pressure support through a helmet with pressure support through a face mask for subject comfort, breathing pattern, gas exchange, pressurization and triggering performance, and patient-ventilator synchrony. Two 30-min trials of NIV were randomly delivered to 10 subjects with COPD exacerbation. The first group was treated with pressure support through a face mask and the second group with NAVA through a helmet. Several parameters were evaluated including subject comfort, breathing frequency, respiratory drive, arterial blood gases, pressure-time product (PTP) of the first 300 ms and 500ms after initiation of subject effort, inspiratory trigger delay, and rate of asynchrony determined as the asynchrony index. NAVA through a helmet significantly improved comfort compared with pressure support through a face mask. Although the breathing pattern was not different between the methods, the respiratory drive was slightly reduced during NAVA through a helmet in comparison with pressure support through a face mask. Gas exchange was also not different between the trials. The PTP was comparable between trials, whereas triggering performance, patient-ventilator interaction, and synchrony were all improved by NAVA through a helmet compared with pressure support through a face mask. Therefore, in subjects with COPD with exacerbation, NAVA through a helmet improved comfort, triggering performance, and patient-ventilator synchrony compared with pressure support through a face mask.
Link to abstract
Cammarota G, Longhini F, Perucca R, Ronco C, Colombo D, Messina A, Vaschetto R, Navalesi P.
Anesthesiology. 2016 Dec;125(6):1181-1189
Randomised trial of 15 patients undergoing three 30-minutes ventilation trials using two different helmets. The ventiltion modes were randomly applied: pneumatically triggered pressure support ventilation (PSP), neurally adjusted ventilatory assist (NAVA) and neurally controlled pressure support (PSN). The latter is a new proposed setting of the NAVA mode. Authors conclude that PSN improves comfort and patient-ventilator interactions in this scenario.
Link to abstract.