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The study compares two different ventilation modes, Pressure support ventilation vs. Neuronally Adjusted Ventilatory Assist, in postcardiac surgery patients. Of special interest is shunt and alveolar deadspace and ventral vs. dorsal ventilation.
The aim of the study is to compare two different ventilation modes in complicated postcardiac surgery patients, who need ventilatory support during weaning phase, in the Cardiothoracic Intensive Care Unit. The two different ventilation modes are Neuronally Adjusted Ventilatory Assist (NAVA) and Pressure Support ventilation. NAVA ventilation mode have been introduced a couple of years ago as an alternative to pressure support. The advantage of NAVA mode compared to pressure support is a better synchrony between patient and ventilator in the inspired and expired phases. Maybe there are also physiological advantages of the NAVA mode, which we want to study in the present study.
All patients have three measurement periods. 1) Pressure support during 20 min, NAVA equilibration period of 30 min, followed by 2) NAVA ventilation for 20 min, pressure support equilibration period of 30 min and 3) pressure support for 20 min. Blood gases and cardiac output measurements is performed before and after each measurement period. Regional ventilation is measured by Electric Impedance Tomography (EIT).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| NAVA vs Pressure Support | Other | Control (pressure support) - NAVA - Control (Pressure Support) Intervention is NAVA |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NAVA | Device | Neurally Adjusted Ventilatory Assist is a fairly new ventilation mode |
|
| Measure | Description | Time Frame |
|---|---|---|
| Ventilation distribution | Redistribution of ventilation , dorsally vs. ventrally | Through study completion, within approximately 18 months |
| Alveolar dead space | Calculated from blood gases and end tidal pCO2,using standard formulae | Through study completion, within approximately 18 months |
| End expiratory lung impedance | Measured by Electric Impedance Tomography | Through study completion, within approximately 18 months |
| PaO2/FiO2 | Arterial oxygenation | Through study completion, within approximately 18 months |
| Alveolar shunt | Calculated from mixed venous and arterial blood gases | Through study completion, within approximately 18 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Anders Thoren, MD, PhD | University of Goteborg | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sahlgrenska University Hospital | Gothenburg | 41345 | Sweden |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41423634 | Derived | Martinsson A, Lundholm C, Ricksten SE, Oras J, Magnusson JM, Wallinder A, Sellgren J, Thoren A. Neurally adjusted ventilatory assist vs pressure support ventilation: short-term effects on shunt and dead space after cardiac surgery. Sci Rep. 2025 Dec 21;15(1):44234. doi: 10.1038/s41598-025-33097-1. |
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Control-Intervention-Control
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The investigator works as physician at the Department of Intensive Care. The participants are patients.
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