Neural Breathing Pattern and Patient-Ventilator Interaction During Neurally Adjusted Ventilatory Assist and Conventional Ventilation in Newborns

Objective: To compare neurally adjusted ventilatory assist and conventional ventilation on patient-ventilator interaction and neural breathing patterns, with a focus on central apnea in preterm infants. Design: Prospective, observational cross-over study of intubated and ventilated newborns. Data were collected while infants were successively ventilated with three different ventilator conditions (30 min each period): 1) synchronized intermittent mandatory ventilation (SIMV) combined with pressure support at the clinically prescribed, SIMV with baseline settings (SIMVBL), 2) neurally adjusted ventilatory assist, 3) same as SIMVBL, but with an adjustment of the inspiratory time of the mandatory breaths (SIMV with adjusted settings [SIMVADJ]) using feedback from the electrical activity of the diaphragm). Setting: Regional perinatal center neonatal ICU. Patients: Neonates admitted in the neonatal ICU requiring invasive mechanical ventilation. Measurements and Main Results: Twenty-three infants were studied, with median (range) gestational age at birth 27 weeks (24–41 wk), birth weight 780 g (490–3,610 g), and 7 days old (1–87 d old). Patient ventilator asynchrony, as quantified by the NeuroSync index, was lower during neurally adjusted ventilatory assist (18.3% ± 6.3%) compared with SIMVBL (46.5% ±11.7%; p
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Neonatal Intensive Care Source Type: research

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Hi, I am Peter Gloviczki from Mayo Clinic, Editor-in-Chief of the Journal of Vascular Surgery. I am pleased to introduce to you some exciting papers from the March issue of the Journal of Vascular Surgery.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Journal of Vascular Surgery – March 2019 Audiovisual Summary Source Type: research
News items of interest to the vascular surgeon must be received at least 8 weeks before the desired month of publication. Announcements published at no charge include those received from a sponsoring society of this Journal, those courses and conferences sponsored by state, regional, national, or international vascular surgical organizations, and university-sponsored continuing medical education courses. Send applicable events to Andrew O ’Brien, Journal Manager, at a.obrien@elsevier.com. All other news items selected for publication carry a charge of $60.00 US for each insertion, and the fee must accompany the request to publish.
Source: Journal of Vascular Surgery - Category: Surgery Source Type: research
Communications regarding original articles and editorial management should be addressed to Peter Gloviczki, MD, and Peter F. Lawrence, MD, Editors, Journal of Vascular Surgery, 633 N. St. Clair, 22nd Floor, Chicago, IL 60611; telephone: 603-523-2222; fax: 312-334-2320; e-mail: JVASCSURG@vascularsociety.org. Information for authors appears in the January and July issues, at www.jvascsurg.org, and at jvs.editorialmanager.com. Authors should consult this document before submitting manuscripts to this Journal.
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