RT Journal Article
SR Electronic
T1 Neurally Adjusted Ventilatory Assist During Weaning From Respiratory Support in a Case of Guillain-Barré Syndrome
JF Respiratory Care
FD American Association for Respiratory Care
SP e68
OP e72
DO 10.4187/respcare.03507
VO 60
IS 4
A1 Jonathan Dugernier
A1 Emilie Bialais
A1 Gregory Reychler
A1 Marco Vinetti
A1 Philippe Hantson
YR 2015
UL http://rc.rcjournal.com/content/60/4/e68.abstract
AB We report a case of Guillain-Barré syndrome complicated by respiratory failure requiring mechanical ventilation. Neurally adjusted ventilatory assist (NAVA) allowed proper patient-ventilator synchronization by pressure support proportional to the electrical activity of the diaphragm (Edi). Prolonged ventilation with NAVA seems feasible in patients with neuromuscular impairment, but the weaning process conducted by a continuous monitoring of Edi for pressure support titration needed to be assessed in a Guillain-Barré syndrome patient. Beginning on day 12 after hospital admission, the patient was ventilated with NAVA for 8 d. The NAVA level (pressure support per unit of Edi) was decreased from 1.2 cm H2O/μV to zero over the 8-d period. A simultaneous decrease in the tidal volume/Edi ratio was interpreted as a sign of recovery. A spontaneous breathing trial was successfully performed on day 20, followed by decannulation 4 d later. In conclusion, NAVA should be further investigated in patients with Guillain-Barré syndrome, particularly during the weaning period.