Study of Electrical Activity of the Diaphragm and Breathing Mechanics During NAVA Ventilation in Lung Transplant and Acute Respiratory Failure Patients

What this Trial Is About

Researchers are studying protective ventilatory strategies to reduce lung injury caused by mechanical ventilation in patients after lung transplantation or those experiencing acute respiratory failure requiring invasive ventilation. This research focuses on a ventilation mode called Neurally Adjusted Ventilatory Assist NAVA, which uses the electrical activity of the diaphragm EAdi to coordinate breathing support. The study aims to explore how neural respiratory drive relates to tidal volume, driving pressure, and mechanical power at different assist levels, especially when pulmonary vagal afferent feedback is absent. Participants will receive NAVA ventilation, an assisted mode synchronized with their inspiratory effort through an EAdi catheter, which adjusts support proportional to their respiratory drive. The study evaluates these relationships during the early postoperative period after lung transplantation and in critically ill patients with acute respiratory failure. Additional respiratory parameters such as muscle pressure, occlusion pressure, and transpulmonary pressure will also be collected. During the trial, participants will be monitored one hour after regaining spontaneous breathing. Measurements include electrical activity of the diaphragm, tidal volume, respiratory rate, driving pressure, and occlusion pressure. Sedation levels and spontaneous breathing activity will be assessed, and researchers will track ventilation mechanics to better understand how NAVA affects breathing. The study continues until December 2025, focusing on these physiological outcomes without masking or placebo controls.

Electrical Activity of the Diaphragm and Respiratory Mechanics During NAVA