Recording of a left ventricle assist device electrical current with a neurally adjusted ventilation assist (NAVA) catheter: a small case series.
Edi
LVAD
NAVA
Neurally adjusted ventilatory assist
Journal
Journal of clinical monitoring and computing
ISSN: 1573-2614
Titre abrégé: J Clin Monit Comput
Pays: Netherlands
ID NLM: 9806357
Informations de publication
Date de publication:
12 2023
12 2023
Historique:
received:
29
03
2023
accepted:
27
06
2023
medline:
16
11
2023
pubmed:
17
7
2023
entrez:
17
7
2023
Statut:
ppublish
Résumé
Neurally Adjusted Ventilatory Assist (NAVA) is an adaptive ventilation mode that recognizes electromyographic diaphragmatic activation as a sensory input to control the ventilator. NAVA may be of interest in prolonged mechanical ventilation and weaning, as it provides effort-adapted support, improves patient-ventilator synchronization, and allows additional monitoring of neuromuscular function and drive. Ventricular assist devices (VAD), especially for the left ventricle (LVAD), are increasingly entering clinical practice, and intensivists are faced with distinct challenges such as the interaction between the system and other measures of organ support. We present two cases in which a NAVA mode was intended to support ventilator weaning in patients with recent LVAD implantation (HeartMate III An implanted LVAD can render the NAVA signal unusable for ventilatory support because the LVAD signal can interfere with the recording of electromyographic activation of the diaphragm. Therefore, patients with implanted LVAD may need other modes of ventilation than NAVA for advanced weaning strategies.
Sections du résumé
BACKGROUND
Neurally Adjusted Ventilatory Assist (NAVA) is an adaptive ventilation mode that recognizes electromyographic diaphragmatic activation as a sensory input to control the ventilator. NAVA may be of interest in prolonged mechanical ventilation and weaning, as it provides effort-adapted support, improves patient-ventilator synchronization, and allows additional monitoring of neuromuscular function and drive. Ventricular assist devices (VAD), especially for the left ventricle (LVAD), are increasingly entering clinical practice, and intensivists are faced with distinct challenges such as the interaction between the system and other measures of organ support.
CASE PRESENTATION
We present two cases in which a NAVA mode was intended to support ventilator weaning in patients with recent LVAD implantation (HeartMate III
DISCUSSION/CONCLUSIONS
An implanted LVAD can render the NAVA signal unusable for ventilatory support because the LVAD signal can interfere with the recording of electromyographic activation of the diaphragm. Therefore, patients with implanted LVAD may need other modes of ventilation than NAVA for advanced weaning strategies.
Identifiants
pubmed: 37458915
doi: 10.1007/s10877-023-01055-9
pii: 10.1007/s10877-023-01055-9
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1635-1639Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Nature B.V.
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