| Title |
Roles of neurally adjusted ventilatory assist in improving gas exchange in a severe acute respiratory distress syndrome patient after weaning from extracorporeal membrane oxygenation: a case report
|
|---|---|
| Published in |
Journal of Intensive Care, April 2016
|
| DOI | 10.1186/s40560-016-0153-4 |
| Pubmed ID | |
| Authors |
Yuya Goto, Shinshu Katayama, Atsuko Shono, Yosuke Mori, Yuya Miyazaki, Yoko Sato, Makoto Ozaki, Toru Kotani |
| Abstract |
Patient-ventilator asynchrony is a major cause of difficult weaning from mechanical ventilation. Neurally adjusted ventilatory assist (NAVA) is reported useful to improve the synchrony in patients with sustained low lung compliance. However, the role of NAVA has not been fully investigated. The patient was a 63-year-old Japanese man with acute respiratory distress syndrome secondary to respiratory infection. He was treated with extracorporeal membrane oxygenation for 7 days and survived. Dynamic compliance at withdrawal of extracorporeal membrane oxygenation decreased to 20 ml/cmH2O or less, but gas exchange was maintained by full support with assist/control mode. However, weaning from mechanical ventilation using a flow trigger failed repeatedly because of patient-ventilator asynchrony with hypercapnic acidosis during partial ventilator support despite using different types of ventilators and different trigger levels. Weaning using NAVA restored the regular respiration and stable and normal acid-base balance. Electromyographic analysis of the diaphragm clearly showed improved triggering of both the start and the end of spontaneous inspiration. Regional ventilation monitoring using electrical impedance tomography showed an increase in tidal volume and a ventilation shift to the dorsal regions during NAVA, indicating that NAVA could deliver gas flow to the dorsal regions to adjust for the magnitude of diaphragmatic excursion. NAVA was applied for 31 days, followed by partial ventilatory support with a conventional flow trigger. The patient was discharged from the intensive care unit on day 110 and has recovered enough to be able to live without a ventilatory support for 5 h per day. Our experience showed that NAVA improved not only patient-ventilator synchrony but also regional ventilation distribution in an acute respiratory distress patient with sustained low lung compliance. |
X Demographics
The data shown below were collected from the profiles of 6 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Venezuela, Bolivarian Republic of | 1 | 17% |
| United Kingdom | 1 | 17% |
| Saudi Arabia | 1 | 17% |
| Unknown | 3 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 4 | 67% |
| Science communicators (journalists, bloggers, editors) | 1 | 17% |
| Practitioners (doctors, other healthcare professionals) | 1 | 17% |
Mendeley readers
The data shown below were compiled from readership statistics for 30 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Colombia | 1 | 3% |
| Unknown | 29 | 97% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 5 | 17% |
| Researcher | 5 | 17% |
| Professor > Associate Professor | 3 | 10% |
| Student > Ph. D. Student | 3 | 10% |
| Professor | 3 | 10% |
| Other | 4 | 13% |
| Unknown | 7 | 23% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 13 | 43% |
| Nursing and Health Professions | 4 | 13% |
| Engineering | 2 | 7% |
| Psychology | 1 | 3% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 3% |
| Other | 0 | 0% |
| Unknown | 9 | 30% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 April 2016.
All research outputs
#12,757,506
of 22,860,626 outputs
Outputs from Journal of Intensive Care
#298
of 515 outputs
Outputs of similar age
#134,963
of 301,014 outputs
Outputs of similar age from Journal of Intensive Care
#15
of 19 outputs
Altmetric has tracked 22,860,626 research outputs across all sources so far. This one is in the 43rd percentile – i.e., 43% of other outputs scored the same or lower than it.
So far Altmetric has tracked 515 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.7. This one is in the 41st percentile – i.e., 41% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 301,014 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 54% of its contemporaries.
We're also able to compare this research output to 19 others from the same source and published within six weeks on either side of this one. This one is in the 21st percentile – i.e., 21% of its contemporaries scored the same or lower than it.