Titration of analgosedation with neurally adjusted ventilatory assist in the ICU

Excerpt

The patient-ventilator asynchrony (PVA) is a cause of oversedation that prolongs mechanical ventilation unnecessarily. The current tools for measurement of sedation are inadequate for assessing the PVA. Neurally adjusted ventilatory assist (NAVA) is an innovative ventilatory mode that provides an excellent real-time monitor of the neural signal of diaphragmatic electrical activity (EAdi) and consequently highlights the PVA. Whether EAdi can be of help to titrate the level of sedation has not yet been proved, so we want to verify this conjecture. To titrate the level of analgosedation, we used this signal, which informs us continuously on changes in lung mechanics and synchrony. …