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Table 4 Impact of ventilator mode and level of assistance on patient-ventilator interaction and asynchrony indices

From: Neurally adjusted ventilatory assist and proportional assist ventilation both improve patient-ventilator interaction

 

PSV

NAVA

PAV

Inspiratory trigger delay (msec)

   

 level50

162 (109–241)

157 (138–289)

185 (140–305)

 level100

170 (140–282)

124 (100–238)

224 (176–280)£

 level150

266 (140–427)

164 (99–278)*

201 (166–317)

Expiratory trigger delay (msec)

   

 level50

156 (112–191)

151 (125–175)

152 (107–175)

 level100

212 (176–273)

157 (140–188)*

182 (116–230)

 level150

255 (227–541)

146 (131–218)*

225 (169–333)

Relationship between Pmax and EAdimax (r2)

   

 level50

0.02 (0.01-0.04)

0.56 (0.51-0.65)*

0.02 (0.00-0.04)£

 level100

0.03 (0.01-0.08)

0.85 (0.78-0.90)*

0.04 (0.00-0.07)£

 level150

0.03 (0.01-0.06)

0.64 (0.43-0.88)*

0.03 (0.02-0.08)£

Relationship between VT and EAdiAUC (r2)

   

 level50

0.15 (0.14-0.19)

0.48 (0.40-0.57)*

0.39 (0.25-0.45)*

 level100

0.13 (0.06-0.22)

0.64 (0.60-0.79)*

0.29 (0.21-0.42)

 level150

0.02 (0.01-0.06)

0.72 (0.65-0.88)*

0.28 (0.25-0.41)*

Ineffective efforts (n.min−1)

   

 level50

0.00 (0.00-0.07)

0.00 (0.00-0.00)*

0.00 (0.00-0.00)*

 level100

0.03 (0.00-0.26)

0.00 (0.00-0.00)*

0.00 (0.00-0.00)*

 level150

0.27 (0.01-1.23)

0.00 (0.00-0.00)*

0.00 (0.00-0.00)*

Auto-triggering (n.min−1)

   

 level50

0.00 (0.00-0.03)

0.00 (0.00-0.00)

0.00 (0.00-0.00)

 level100

0.00 (0.00-0.03)

0.00 (0.00-0.00)

0.00 (0.00-0.00)

 level150

0.00 (0.00-0.00)

0.00 (0.00-0.00)

0.00 (0.00-0.00)

Double triggering (n.min−1)

   

 level50

0.00 (0.00-0.00)

0.42 (0.08-0.50)*

0.00 (0.00-0.00)£

 level100

0.00 (0.00-0.18)

0.33 (0.10-0.92)*

0.00 (0.00-0.10)£

 level150

0.00 (0.00-0.21)

0.30 (0.02-0.87)*

0.00 (0.00-0.20)£

Asynchrony index (%)

   

 level50

0.21 (0.00-0.65)

1.41 (0.34-2.91)*

0.13 (0.00-0.44)£

 level100

0.61 (0.04-1.28)

1.73 (0.38-2.69)

0.00 (0.00-0.58)£

 level150

1.65 (0.58-5.77)

1.17 (0.05-3.99)

0.19 (0.00-1.12)

  1. EAdiAUC, area under the diaphragmatic electrical activity curve; PSV, pressure support ventilation; NAVA, neurally adjusted ventilatory assist; PAV, proportional assist ventilation; VT, tidal volume. Level100 is a medium assistance level set to obtain a VT of 6to 8 ml/kg ideal body weight. Level50 is a low assistance level defined as level100 decreased by 50%. Level150 is a high assistance level defined as level100 increased by 50%.
  2. The number of each type of asynchrony is reported as the total number of each event per minute. Asynchrony index is defined as the total number of asynchrony events × 100/(ventilator respiratory rate + ineffective efforts).
  3. *P <0.05 with PSV; £ P <0.05 with NAVA; data are expressed as median (interquartile range).