Nichtinvasive Beatmung mit neurally adjusted ventilatory assist (NAVA) im Vergleich zur druckunterstützten Beatmung nach Extubation bei Patienten mit Indikation zur nichtinvasiven Beatmung

Erler, Jana

dc.contributor.advisor	Harnisch, Lars-Olav Dr.
dc.contributor.author	Erler, Jana
dc.date.accessioned	2023-01-10T15:17:52Z
dc.date.available	2023-01-26T00:50:08Z
dc.date.issued	2023-01-10
dc.identifier.uri	http://resolver.sub.uni-goettingen.de/purl?ediss-11858/14445
dc.identifier.uri	http://dx.doi.org/10.53846/goediss-9648
dc.format.extent	96 Seiten	de
dc.language.iso	deu	de
dc.rights.uri	http://creativecommons.org/licenses/by/4.0/
dc.subject.ddc	610	de
dc.title	Nichtinvasive Beatmung mit neurally adjusted ventilatory assist (NAVA) im Vergleich zur druckunterstützten Beatmung nach Extubation bei Patienten mit Indikation zur nichtinvasiven Beatmung	de
dc.type	doctoralThesis	de
dc.contributor.referee	Mörer, Onnen Prof. Dr.
dc.date.examination	2023-01-18	de
dc.description.abstracteng	Introduction: Asynchrony between patient and ventilator is common under conventional pneumatically triggered ventilation procedures such as pressure support ventilation (PSV) and is an important factor in NIV failure. It has been shown that neurally adjusted ventilatory assist (NAVA) can improve patient-ventilator interaction and reduce work of breathing by deriving the EAdi signal. Methods: In this object-blind, randomized crossover study, 22 patients were ventilated in NIV-NAVA and NIV-PSV mode. The breathing curves were recorded, the blood gas values evaluated and the comfort of the patient was recorded. Results: the negative pressure swing (p < 0.001), the inspiratory trigger delay (p < 0.0005) and the expiratory trigger delay (p = 0.003) were significantly shorter under NAVA than under PSV. In NAVA mode, the occurrence of all asynchronous events could be reduced, only double triggering occurred significantly more frequently than under PSV (p = 0.02). Ineffective efforts could be completely avoided under NAVA. The Neuro-Sync index (trigger and cycle-off delays and all forms of asynchrony) was lower under NAVA than under PSV (p < 0.001). The evaluation of blood gas values and patient comfort showed no significant differences. Conclusions: Even if no positive effect on comfort could be proven, the clinical application of NAVA promises efficient and lung-friendly ventilation with reduced work of breathing due to the improved synchronicity between patient and ventilator. In particular, patients with pre-existing respiratory diseases such as severe COPD or acute respiratory distress syndrome (ARDS) could benefit from NAVA. It could be the subject of future studies to include these patient groups. It would also be interesting to compare the intubation rate and outcome of patients under NAVA and PSV.	de
dc.contributor.coReferee	Perl, Thorsten PD Dr.
dc.subject.eng	NIV	de
dc.subject.eng	NAVA	de
dc.subject.eng	PSV	de
dc.subject.eng	noninvasive	de
dc.subject.eng	ventilation	de
dc.subject.eng	asynchrony	de
dc.identifier.urn	urn:nbn:de:gbv:7-ediss-14445-8
dc.affiliation.institute	Medizinische Fakultät	de
dc.subject.gokfull	Anästhesiologie / Intensivmedizin / Notfallmedizin / Analgesie - Allgemein- und Gesamtdarstellungen (PPN619875917)	de
dc.description.embargoed	2023-01-26	de
dc.identifier.ppn	1830723286
dc.creator.birthname	Mann	de
dc.identifier.orcid	0000-0003-0930-5030	de
dc.notes.confirmationsent	Confirmation sent 2023-01-10T15:45:01	de

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Human- und Zahnmedizin [2872]

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