Mechanical Ventilation and Respiratory Muscle Work of Breathing in Acute Respiratory Distress Syndrome (ARDS) Patients

The Role of Diaphragm Electromyography (EMG) Guided Mechanical Ventilation on Respiratory Physiology in Mechanically Ventilated Patients With Acute Respiratory Distress Syndrome (ARDS)

The purpose of this study is to demonstrate that mechanical ventilation guided by the diaphragm EMG signal (also know as neurally adjusted ventilatory assist [NAVA]) is superior compared to pressure support and pressure control ventilation.

Inclusion Criteria:

• intubated, mechanically ventilated patients
• meeting criteria for ARDS
• mean arterial blood pressure > 65 mmHg (with or w/o vasopressors)

Exclusion Criteria:

• pregnancy
• increased intracranial pressure
• contra-indication naso-gastric tube
• diagnosed neuro-muscular disorder
• recent (<12 hours) use of muscle relaxants
• exclusion from sedation interruption protocol as used in our institution
• open chest or- abdomen
• very high inspiratory flow rate during supported ventilation
• inability to obtain informed consent