Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Critical Care Medicine

Introduction: Asynchronies between patient and mechanical ventilator despite optimal adjustment of ventilator parameters are common problem that is partly associated with difficult weaning of mechanical ventilator. NAVA is a mode of proportional ventilation that count on diaphragmatic activity (measured by special esophageal probe and expressed as Edi) to provide proportional support to patient effort which differs from one breath to another according to Edi signal. Patients and Methods: This is a prospective randomized control study conducted on 30 critically ill, invasively ventilated patients admitted to the ICU of Suez Canal Authority Hospital during the period from June 2017 till August 2018. Patients were randomly divided into two groups: group A include fifteen patients were ventilated in PSV (as a weaning mode) only and evaluated for successful weaning and group B: Fifteen Patients were successively ventilated for 24 h using PSV and then they were ventilated for another 24 h in the NAVA (as a weaning mode). The patient{u2019}s physician optimized the ventilator settings in the particular PSV mode to limit the appearance of asynchronies.The incidence of different types of desynchrony was compared between the two modes, then group B patients were evaluated for successful weaning using NAVA and compared to group A

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