Changes in Respiratory Patterns From Pressure Control Ventilation to Neurally Adjusted Ventilatory Assist Assessed by Electrical Impedance Tomography

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Auteurs principaux: Marika Rahtu, Inéz Frerichs, Tobias H. Becher, Tytti Pokka, Andreas D. Waldmann, Thalia Papadouri, Anton H. van Kaam, Peter C. Rimensberger, Richard Bayford, Outi Peltoniemi, Merja Kallio
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Publié: Wiley 2025
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author Marika Rahtu
Inéz Frerichs
Tobias H. Becher
Tytti Pokka
Andreas D. Waldmann
Thalia Papadouri
Anton H. van Kaam
Peter C. Rimensberger
Richard Bayford
Outi Peltoniemi
Merja Kallio
author_facet Marika Rahtu
Inéz Frerichs
Tobias H. Becher
Tytti Pokka
Andreas D. Waldmann
Thalia Papadouri
Anton H. van Kaam
Peter C. Rimensberger
Richard Bayford
Outi Peltoniemi
Merja Kallio
Marika Rahtu
Inéz Frerichs
Tobias H. Becher
Tytti Pokka
Andreas D. Waldmann
Thalia Papadouri
Anton H. van Kaam
Peter C. Rimensberger
Richard Bayford
Outi Peltoniemi
Merja Kallio
collection Wiley Open Access
contents Changes in Respiratory Patterns From Pressure Control Ventilation to Neurally Adjusted Ventilatory Assist Assessed by Electrical Impedance Tomography Marika Rahtu Inéz Frerichs Tobias H. Becher Tytti Pokka Andreas D. Waldmann Thalia Papadouri Anton H. van Kaam Peter C. Rimensberger Richard Bayford Outi Peltoniemi Merja Kallio Pediatric Pulmonology ABSTRACTIntroductionNeurally Adjusted Ventilatory Assist (NAVA) is increasingly used as ventilatory support for preterm infants. Changes in ventilation distribution and respiratory patterns during the transition from patient‐triggered time‐cycled Pressure Controlled Ventilation (PCV) to NAVA have not yet been studied. This study aimed to evaluate the impact of ventilation mode (PCV and NAVA, respectively) on ventilation distribution and breathing patterns in preterm infants with Electrical Impedance Tomography.MethodsThis study included 16 premature infants at Oulu University Hospital who participated in the observational CRADL project and were on NAVA. EIT data was retrospectively assessed by choosing a 1‐min stable recording before and after the change from one to the other mode. The primary endpoint was changes in global and regional ventilation parameters (ΔZ), and the secondary endpoints were Centers of Ventilation (CoVs), the amount of silent spaces, and the duration of inspiratory and respiratory cycle times.ResultsA larger variation in the global tidal impedance variation (p < 0.05) and the respiratory cycle time (p < 0.05) was observed on NAVA than on PCV. Sighs, which were determined as a breath impedance change twice the size of an average breath on PCV, were more frequent during NAVA than PCV (5.1% vs 0.8%, respectively). Mean global or regional impedance variations or silent spaces did not differ between PCV and NAVA.ConclusionNAVA allowed more variable breathing patterns during invasive respiratory support than patient‐triggered PCV. However, variability in the respiratory cycle did not lead to systematic changes in ventilation distribution or silent spaces. 10.1002/ppul.71077 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1002/ppul.71077
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publisher Wiley
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spellingShingle Changes in Respiratory Patterns From Pressure Control Ventilation to Neurally Adjusted Ventilatory Assist Assessed by Electrical Impedance Tomography
Marika Rahtu
Inéz Frerichs
Tobias H. Becher
Tytti Pokka
Andreas D. Waldmann
Thalia Papadouri
Anton H. van Kaam
Peter C. Rimensberger
Richard Bayford
Outi Peltoniemi
Merja Kallio
Pediatric Pulmonology
Changes in Respiratory Patterns From Pressure Control Ventilation to Neurally Adjusted Ventilatory Assist Assessed by Electrical Impedance Tomography Marika Rahtu Inéz Frerichs Tobias H. Becher Tytti Pokka Andreas D. Waldmann Thalia Papadouri Anton H. van Kaam Peter C. Rimensberger Richard Bayford Outi Peltoniemi Merja Kallio Pediatric Pulmonology ABSTRACTIntroductionNeurally Adjusted Ventilatory Assist (NAVA) is increasingly used as ventilatory support for preterm infants. Changes in ventilation distribution and respiratory patterns during the transition from patient‐triggered time‐cycled Pressure Controlled Ventilation (PCV) to NAVA have not yet been studied. This study aimed to evaluate the impact of ventilation mode (PCV and NAVA, respectively) on ventilation distribution and breathing patterns in preterm infants with Electrical Impedance Tomography.MethodsThis study included 16 premature infants at Oulu University Hospital who participated in the observational CRADL project and were on NAVA. EIT data was retrospectively assessed by choosing a 1‐min stable recording before and after the change from one to the other mode. The primary endpoint was changes in global and regional ventilation parameters (ΔZ), and the secondary endpoints were Centers of Ventilation (CoVs), the amount of silent spaces, and the duration of inspiratory and respiratory cycle times.ResultsA larger variation in the global tidal impedance variation (p < 0.05) and the respiratory cycle time (p < 0.05) was observed on NAVA than on PCV. Sighs, which were determined as a breath impedance change twice the size of an average breath on PCV, were more frequent during NAVA than PCV (5.1% vs 0.8%, respectively). Mean global or regional impedance variations or silent spaces did not differ between PCV and NAVA.ConclusionNAVA allowed more variable breathing patterns during invasive respiratory support than patient‐triggered PCV. However, variability in the respiratory cycle did not lead to systematic changes in ventilation distribution or silent spaces. 10.1002/ppul.71077 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Changes in Respiratory Patterns From Pressure Control Ventilation to Neurally Adjusted Ventilatory Assist Assessed by Electrical Impedance Tomography
topic Pediatric Pulmonology
url https://onlinelibrary.wiley.com/doi/10.1002/ppul.71077