Reverse Triggered Breath during Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist at Increasing Propofol Infusion

被引:4
作者
Longhini, Federico [1 ]
Simonte, Rachele [2 ]
Vaschetto, Rosanna [3 ]
Navalesi, Paolo [4 ]
Cammarota, Gianmaria [3 ]
机构
[1] Magna Graecia Univ Catanzaro, Dept Med & Surg Sci, Anesthesia & Intens Care, I-88100 Catanzaro, Italy
[2] Univ Perugia, Hosp S Maria Misericordia, Dept Med & Surg, Div Anesthesia Analgesia & Intens Care, I-06123 Perugia, Italy
[3] Eastern Piedmont Univ, Dept Translat Med, Anesthesia & Intens Care, I-28100 Novara, Italy
[4] Univ Padua, Padua Hosp, Dept Med DIMED, Anesthesia & Intens Care, I-35128 Padua, Italy
关键词
pressure support ventilation; neurally adjusted ventilatory assist; propofol; patient-ventilator asynchrony; sedation; reverse triggered breath; MECHANICAL VENTILATION; ASYNCHRONY; CONSEQUENCES; DYSSYNCHRONY; FLOW; ARDS;
D O I
10.3390/jcm12144857
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Reverse triggered breath (RTB) has been extensively described during assisted-controlled modes of ventilation. We aimed to assess whether RTB occurs during Pressure Support Ventilation (PSV) and Neurally Adjusted Ventilatory Assist (NAVA) at varying depths of propofol sedation. Methods: This is a retrospective analysis of a prospective crossover randomized controlled trial conducted in an Intensive Care Unit (ICU) of a university hospital. Fourteen intubated patients for acute respiratory failure received six trials of 25 minutes randomly applying PSV and NAVA at three different propofol infusions: awake, light, and deep sedation. We assessed the occurrence of RTBs at each protocol step. The incidence level of RTBs was determined through the RTB index, which was calculated by dividing RTBs by the total number of breaths triggered and not triggered. Results: RTBs occurred during both PSV and NAVA. The RTB index was greater during PSV than during NAVA at mild (1.5 [0.0; 5.3]% vs. 0.6 [0.0; 1.1]%) and deep (5.9 [0.7; 9.0]% vs. 1.7 [0.9; 3.5]%) sedation. Conclusions: RTB occurs in patients undergoing assisted mechanical ventilation. The level of propofol sedation and the mode of ventilation may influence the incidence of RTBs.
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页数:8
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