Abstract：
BACKGROUND:The use of neurally-adjusted ventilatory assist (NAVA) during noninvasive ventilation (NIV) results in better patient-ventilator interaction. Whether this improves clinical outcomes lacks dedicated study. METHODS:In this randomized controlled trial, we compared NAVA with PSV for delivering NIV in consecutive subjects with de novo acute respiratory failure. The primary outcomes were NIV failure rates and 28-d mortality. The secondary outcomes were asynchrony index, NIV-related complications, and others. RESULTS:We enrolled 100 subjects (50 subjects each for NAVA and PSV, 60% male) with a mean ± SD age of 56.7 ± 12 y. There was no difference in NIV failure rates (30% vs 32%, P = .83) and 28-d mortality rates (18% vs 34%, P = .07) between the NAVA and PSV arms, respectively. The median asynchrony index was significantly lower with NAVA (6.7 vs 44.8, P < .001). The use of NAVA significantly reduced NIV-related complications (32% vs 58%, P = .01). In a post hoc analysis, the use of NAVA significantly reduced the 28-d mortality in subjects with COPD exacerbation. CONCLUSIONS:The use of NAVA during NIV did not improve NIV failure rate or 28-d mortality in subjects with acute respiratory failure. However, patient-ventilator asynchrony and NIV-related complications were reduced with NAVA. TRIAL REGISTRY:www.clinicaltrials.gov (NCT03271671).
journal_name
Respir Carejournal_title
Respiratory careauthors
Prasad KT,Gandra RR,Dhooria S,Muthu V,Aggarwal AN,Agarwal R,Sehgal ISdoi
10.4187/respcare.07952subject
Has Abstractpub_date
2021-02-01 00:00:00pages
213-220issue
2eissn
0020-1324issn
1943-3654pii
respcare.07952journal_volume
66pub_type
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