Recording of a left ventricle assist device electrical current with a neurally adjusted ventilation assist (NAVA) catheter: a small case series.
J Clin Monit Comput
; 37(6): 1635-1639, 2023 12.
Article
en En
| MEDLINE
| ID: mdl-37458915
BACKGROUND: Neurally Adjusted Ventilatory Assist (NAVA) is an adaptive ventilation mode that recognizes electromyographic diaphragmatic activation as a sensory input to control the ventilator. NAVA may be of interest in prolonged mechanical ventilation and weaning, as it provides effort-adapted support, improves patient-ventilator synchronization, and allows additional monitoring of neuromuscular function and drive. Ventricular assist devices (VAD), especially for the left ventricle (LVAD), are increasingly entering clinical practice, and intensivists are faced with distinct challenges such as the interaction between the system and other measures of organ support. CASE PRESENTATION: We present two cases in which a NAVA mode was intended to support ventilator weaning in patients with recent LVAD implantation (HeartMate III®). However, in these patients, the electrical activity of the diaphragm (Edi) could not be used to control the ventilator, because the LVAD current detected by the catheter superposed the Edi current, making usage of this mode impossible. DISCUSSION/CONCLUSIONS: An implanted LVAD can render the NAVA signal unusable for ventilatory support because the LVAD signal can interfere with the recording of electromyographic activation of the diaphragm. Therefore, patients with implanted LVAD may need other modes of ventilation than NAVA for advanced weaning strategies.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Corazón Auxiliar
/
Soporte Ventilatorio Interactivo
Límite:
Humans
Idioma:
En
Revista:
J Clin Monit Comput
Asunto de la revista:
INFORMATICA MEDICA
/
MEDICINA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Alemania
Pais de publicación:
Países Bajos