Neurally adjusted ventilatory assist after surgical treatment of intracerebral hemorrhage: a randomized crossover study

Abstract

Objective: We assessed the neuromechanical efficiency (NME), neuroventilatory efficiency (NVE), and diaphragmatic function effects between pressure support ventilation (PSV) and neutrally adjusted ventilatory assist (NAVA). Methods: Fifteen patients who had undergone surgical treatment of intracerebral hemorrhage were enrolled in this randomized crossover study. The patients were assigned to PSV for the first 24 hours and then to NAVA for the following 24 hours or vice versa. The monitored ventilatory parameters under the two ventilation models were compared. NME, NVE, and diaphragmatic function were compared between the two ventilation models. Results: One patient’s illness worsened during the study. The study was stopped for this patient, and intact data were obtained from the other 14 patients and analyzed. The monitored tidal volume was significantly higher with PSV than NAVA (487 [443–615] vs. 440 [400–480] mL, respectively). NME, NVE, diaphragmatic function, and the partial pressures of arterial carbon dioxide and oxygen were not significantly different between the two ventilation models. Conclusion: The tidal volume was lower with NAVA than PSV; however, the patients’ selected respiratory pattern during NAVA did not change the NME, NVE, or diaphragmatic function. Clinical trial registration no. ChiCTR1900022861