Neurally Adjusted Ventilatory Assist versus Pressure Support Ventilation during weaning A meta-analysis of randomized trials

Abstract

Background: Prolonged ventilatory support is associated with poor clinical outcomes. pressure support ventilation modes , are frequently used in clinical practice but are associated with patient–ventilator asynchrony and deliver fixed levels of assist. Neurally adjusted ventilatory assist (NAVA), a mode of partial ventilatory assist that reduces patient–ventilator asynchrony compared with other partial support modes for patients with difficult weaning Objectives:conduct a meta-analysis comparing neurally adjusted ventilatory assist (NAVA) with pressure support ventilation (PSV) in adult ventilated patients &clinical outcomes. Study design: Meta-analysis was used to address this concern. Sittings: Meta-analysis-based study following the PRISMA (Preferred Reporting Items for Systematic Reviews and MetaAnalyses) guidelines. Methods: Online databases (PubMed, Embase, BioMed, and the Cochrane Central Register of Controlled trials) were used for randomized studies ever performed in humans with NAVA & PSV in any clinical setting. Results: 12 studies (n = 799 patients) were included. Regarding the primary outcome, patients weaned with NAVA had a higher success rate compared with pressure support ventilation For the secondary outcomes, NAVA may reduce duration of mechanical ventilation and hospital mortality and prolongs ventilator-free days when compared with other modes. Conclusion: Our study suggests that the NAVA mode may improve the rate of weaning success compared with pressure support ventilation for difficult weaning