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This study evaluates the difference between Non Invasive Ventilation with Neurally Adjusted Ventilatory Assist (NIV-NAVA) and Conventional Non Invasive Ventilation with Pressure Support (PS) or Pressure Control (PC). All the patients are ventilated in each mode for 4 hours. Afterwards they will be subjected to a semi-structured interview where they will be asked to compare the two modes. The hypothesis is that NIV-NAVA will correct patients power of Hydrogen (pH), PaCO2 og PaO2 more quickly than NIV-PS and NIV-NAVA is more comfortable for the patients.
Neurally Adjusted Ventilatory Assist (NAVA) is a ventilation mode where the diaphragm is controlling the amount of ventilatory assistance proportionally through a nasogastric tube containing electrodes which are sending the electrical activities of the diaphragm (Eadi) to the ventilator.
Whereas Conventional ventilation modes like Pressure support or Pressure Control are dependent on the pressure drop or flow reversal to initiate assist delivered to the patient. This is last step of the signal chain leading to inhalation and is subject to disturbances such as intrinsic positive expiratory end pressure (PEEP), hyperinflation and leakage.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| NIV-NAVA | 4 hour NIV-NAVA, followed by 4 hour NIV-PS/PC |
| |
| NIV-PS/PC | 4 hour NIV-PS/PC, followed by 4 hour NIV-NAVA |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NIV-NAVA | Other | Cross-over study where participants are randomized to start with either NIV-NAVA or NIV-PS/PC for 4 hours, followed by another 4 hours with the other arm. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Time for normalizing of Power of Hydrogen (pH) in arterial blood gases. Normal pH frame 7.35-7.45. | 8 hours | |
| Time for normalizing of Partial pressure of Oxygen (pO2) in arterial blood gases. Normal frame for pO2 7-14,4 (or to the usual level for the patient). | 8 hours | |
| Time for normalizing Carbon dioxide partial pressure (pCO2) in arterial blood gases. Normal frames pCO2 4,7-6,4 (or to the usual level for the patient). | 8 hours | |
| Electrical activity of the diaphragm (Eadi). Reduction in respiratory work assessed by Eadi (in percentage). | 8 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Patient comfort | There will be conducted a semi-interview on the subjects. They will be asked: If they felt any difference in breathing between the two modes. If yes, what was the difference? Which method did you prefer? And why? Do you have any comments? | 24 hours |
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Inclusion Criteria:
Exclusion Criteria:
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Patients admitted to the ICU at Vejle Hospital, Denmark, with acute respiratory insufficiency.
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| Name | Affiliation | Role |
|---|---|---|
| Alan Kimper-Karl, MD | Vejle Hospital | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Vejle Hospital | Vejle | Southern Jetland | 7100 | Denmark |
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| ID | Term |
|---|---|
| D012131 | Respiratory Insufficiency |
| D000860 | Hypoxia |
| D006935 | Hypercapnia |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D012818 | Signs and Symptoms, Respiratory |
| D012816 | Signs and Symptoms |
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| NIV-PS/PC | Other | Cross-over study where participants are randomized to start with either NIV-NAVA or NIV-PS/PC for 4 hours, followed by another 4 hours with the other arm. |
|
| D013568 | Pathological Conditions, Signs and Symptoms |