i nava neurally adjusted ventilatory assist overview€¦ · overview . servo-i nava 2. servo-i...
Post on 26-Sep-2020
2 Views
Preview:
TRANSCRIPT
Servoi NAVANeurally Adjusted Ventilatory Assist
Overview
2Servo-i NAVA
5Servo-i NAVA
Neurally Adjusted Ventilatory Assist
Respiratory Control Feedback System
6Servo-i NAVA
Ideal Technology vs. Current Technology
Central nervous system
Phrenic nerve
Diaphragm excitation
Diaphragm contraction
Chest wall, lung and esophageal response
Airway flow, pressure and volume changes
Ideal Technology
Current Technology
Ventilator
PC, VC, PRVC, PS & VS
7Servo-i NAVA 7
NAVA - Edi Catheter
9Servo-i NAVA
Electrical Activity CapturedConverted into Edi Waveform
Ch8Ch7Ch6Ch5Ch4Ch3Ch2Ch1
Phasic
TonicNoise level
Edi signal is averaged 62.5 times per second & transferred to Servo-i.
Edi Peak
Edi Min
10Servo-i NAVA
Edi Catheter Positioning Screen
11Servo-i NAVA
Health Disease
Edi
VT
μV μV μV
ml ml ml
NEUROVENTILATORY COUPLINGFrom Health To Disease
66 75 915 Rev. 01
14Servo-i NAVA
NAVA Parameters
15Servo-i NAVA
NAVA Level
Ppeak in NAVA = NAVA Level x (Edi Peak – Edi Min) + PEEP
18Servo-i NAVA
NAVA Case Study
19Servo-i NAVA
Volume Control with NAVA Preview
20Servo-i NAVA
On NAVA – Expiratory Effort
21Servo-i NAVA
Decreasing NAVA Level and PEEP
22Servo-i NAVA
NIV NAVA Patient
23Servo-i NAVA
NIV NAVA - NAVA Level 1.5Edi Peak 18 (Normal 5 to 15)
24Servo-i NAVA
NAVA Titration Start - NAVA Level 0.0Edi Peak 30 & Vt 418
25Servo-i NAVA
Increase NAVA Level 1.0Edi Peak 14 – Vt 548
26Servo-i NAVA
Patient Information 8/21/2008 – Page 1
CURRENT PROBLEMS & DIAGNOSIS: EXTREME PREMATURITY 27 weeks gestation, born at 1140 grams.
Age: 22 days, Adjusted gestational age: 31 weeks 3 days. Current Weight 1.460 kg Laboratory Studies: 8/21/2008 phenobarbital 66.4 MCG/ML
Current Medications: Phenobarbital, Fentanyl, Ampicillin
Respiratory Support: Ventilator since 8/4/2008 MODE: SIMV PC 12 + PS 5, FiO2: 0.21-0.35 Rate: 35, PEEP: 5 cmH2O, IT: 0.3 sec;
O2 SATS: 89 -100
RESPIRATORY DISTRESS SYNDROME: ONSET: 7/30/2008 STATUS: Active Comments: Patient remains intubated due to recurrent central apnea-likely related to
seizure activity
SEIZURES: ONSET: 7/30/2008 STATUS: Active PROCEDURES: EEG on 8/11/2008 (abnormal) EEG on 8/19/2008 (normal)
MRI 8/19/2008 (no seizure activity-infant on Phenobarbital and Fosphenytoin)
32Servo-i NAVA
NAVA Level 2.0 – Edi Peak 3.2
34Servo-i NAVA
Good Breathing Pattern
41Servo-i NAVA
NIV NAVA – Good Breathing PatternLeak 96%
44Servo-i NAVA
Edi Min ↑Effort = Lung Recruitment
48Servo-i NAVA
On NIV NAVA – NAVA Level 3.0
49Servo-i NAVA
Servoi NAVANeurally Adjusted Ventilatory Assist
top related