Remifentanil effects on respiratory drive and timing during pressure support ventilation and neurally adjusted ventilatory assist

Massimo Antonelli, Giorgio Conti, Roberta Costa, Paolo Navalesi, Gianmaria Cammarota, Giorgia Spinazzola, Flora Cipriani, Giuliano Ferrone, Olimpia Festa, Federico Longhini

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

We assessed the effects of varying doses of remifentanil on respiratory drive and timing in patients receiving Pressure Support Ventilation (PSV) and Neurally Adjusted Ventilatory Assist (NAVA). Four incrementing remifentanil doses were randomly administered to thirteen intubated patients (0.03, 0.05, 0.08, and 0.1μg·Kg−1·min−1) during both PSV and NAVA. We measured the patient's (Ti/Ttotneu) and ventilator (Ti/Ttotmec) duty cycle, the Electrical Activity of the Diaphragm (EAdi), the inspiratory (Delaytrinsp) and expiratory (Delaytrexp) trigger delays and the Asynchrony Index (AI). Increasing doses of remifentanil did not modify EAdi, regardless the ventilatory mode. In comparison to baseline, remifentanil infusion >0.05μg/Kg−1/min−1produced a significant reduction of Ti/Ttotneuand Ti/Ttotmecby prolonging the expiratory time. Delaytrinspand Delaytrexpwere significantly shorter in NAVA, respect to PSV. AI was not influenced by the different doses of remifentanil, but it was significantly lower during NAVA, compared to PSV. In conclusion remifentanil did not affect the respiratory drive, but only respiratory timing, without differences between modes.
Original languageEnglish
Pages (from-to)10-16
Number of pages7
JournalRESPIRATORY PHYSIOLOGY & NEUROBIOLOGY
Volume244
DOIs
Publication statusPublished - 2017

Keywords

  • Adult
  • Aged
  • Critical Care
  • Cross-Over Studies
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Hypnotics and Sedatives
  • Male
  • Middle Aged
  • NAVA
  • Neuroscience (all)
  • PSV
  • Physiology
  • Piperidines
  • Pulmonary and Respiratory Medicine
  • Remifentanil
  • Respiration, Artificial
  • Respiratory Mechanics
  • Respiratory drive
  • Respiratory timing
  • Sedation
  • Time Factors

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