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首页> 外文期刊>BMC Pediatrics >Respiratory support by neurally adjusted ventilatory assist (NAVA) in severe RSV-related bronchiolitis: a case series report
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Respiratory support by neurally adjusted ventilatory assist (NAVA) in severe RSV-related bronchiolitis: a case series report

机译：神经调节通气辅助（NAVA）在严重RSV相关性毛细支气管炎中的呼吸支持：一个病例系列报告

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Background Neurally adjusted ventilatory assist (NAVA) is a new mode of mechanical ventilation controlled by diaphragmatic electrical signals. The electrical signals allow synchronization of ventilation to spontaneous breathing efforts of a child, as well as permitting pressure assistance proportional to the electrical signal. NAVA provides equally fine synchronization of respiratory support and pressure assistance varying with the needs of the child. NAVA has mainly been studied in children who underwent cardiac surgery during the period of weaning from a respirator. Case presentation We report here a series of 3 children (1 month, 3 years, and 28 days old) with severe respiratory distress due to RSV-related bronchiolitis requiring invasive mechanical ventilation with a high level of oxygen (FiO2 ≥50%) for whom NAVA facilitated respiratory support. One of these children had diagnosis criteria for acute lung injury, another for acute respiratory distress syndrome. Establishment of NAVA provided synchronization of mechanical ventilatory support with the breathing efforts of the children. Respiratory rate and inspiratory pressure became extremely variable, varying at each cycle, while children were breathing easily and smoothly. All three children demonstrated less oxygen requirements after introducing NAVA (57 ± 6% to 42 ± 18%). This improvement was observed while peak airway pressure decreased (28 ± 3 to 15 ± 5 cm H2O). In one child, NAVA facilitated the management of acute respiratory distress syndrome with extensive subcutaneous emphysema. Conclusions Our findings highlight the feasibility and benefit of NAVA in children with severe RSV-related bronchiolitis. NAVA provides a less aggressive ventilation requiring lower inspiratory pressures with good results for oxygenation and more comfort for the children.
机译：背景技术神经调节通气辅助（NAVA）是一种由隔膜电信号控制的新型机械通气模式。电信号允许通风与儿童的自发呼吸同步，并允许与电信号成比例的压力辅助。 NAVA可以根据孩子的需求提供同步的呼吸支持和压力帮助。 NAVA主要研究对象是在断奶呼吸器期间接受心脏手术的儿童。病例介绍我们在此报告了3例因RSV相关性细支气管炎而严重呼吸窘迫的3名儿童（分别为1个月，3岁和28天），他们需要进行有氧的高通气性机械通气（FiO 2 50％以下），NAVA为其提供了呼吸支持。这些孩子中的一个具有急性肺损伤的诊断标准，另一个具有急性呼吸窘迫综合征的诊断标准。 NAVA的建立提供了机械通气支持与儿童呼吸努力的同步。呼吸频率和吸气压力变得非常可变，每个周期都有所变化，而儿童则呼吸轻松而顺畅。引入NAVA后，所有三个孩子的氧气需求量均较低（57±6％至42±18％）。当气道峰值压力降低（28±3至15±5 cm H 2 O）时，观察到了这种改善。在一个孩子中，NAVA通过广泛的皮下气肿促进了急性呼吸窘迫综合征的治疗。结论我们的发现强调了NAVA在严重RSV相关性细支气管炎患儿中的可行性和益处。 NAVA通风性较差，需要较低的吸气压力，氧合效果良好，儿童则更舒适。

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