The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts


Richard G. Stairhime, Daniel D. Rowley, Frank J. Caruso; University of Virginia Health System, Charlottesville, VA

BACKGROUND: Respiratory physiologic monitoring and neurally adjusted ventilatory assist (NAVA) are possible during mechanical ventilation with insertion of an electrical activity of the diaphragm (Edi) catheter (Maquet, Sölna, Sweden). Subjective clinician opinions suggest that there is a difference in catheter insertion time based on catheter size (Fr). As part of an ongoing assessment of NAVA, we tested the hypothesis that there is no difference between Edi catheter size and insertion time. METHODS: 50 adult patients between the ages of 31 and 88 (Mean = 60.1 ± 12.1) were conveniently sampled prospectively for catheter insertion based upon need for NAVA. Catheter sizes included 8 Fr/125 cm, 12 Fr/125 cm, and 16 Fr/125 cm. Catheters were inserted by senior level RRTs. Insertion time started when the catheter was inserted into the patient’s nare. Time was stopped when an Edi signal was visualized on the ventilator’s (Servo I; Maquet, Sölna, Sweden) catheter positioning screen. SPSS version 20 (Chicago, IL) was used to apply a Kruskal-Wallis Test to determine if there was a statistically significant difference between catheter size and insertion time. Alpha level was set at .05. Informed consent was waived by the IRB. RESULTS: 50 catheter insertions were attempted. 68% of catheters were 16 Fr/ 125 cm (n = 34), 26% were 12 Fr/125 cm (n = 13), and 6% were 8 Fr/125 cm (n = 3). The 16 Fr/125 cm catheter mean rank = 24.49; 12 Fr/125 cm catheter mean rank = 28.58; 8 Fr/125 cm mean rank = 23.67; χ2 = .84; P = .66. CONCLUSION: There is no statistically significant difference between catheter size and insertion time. Larger studies should evaluate if there is a difference between insertion time and the number of attempted insertions with the addition of a catheter stylet. Sponsored Research - None