the introduction of new MV modalities has shown promising results in reducing the incidence of weaning failure, mainly due to a more physiologic approach which allows respiratory muscle preservation. Among them, the Neurally Adjust Ventilatory Assist (NAVA) seemed to be associated with lower incidence of weaning failure and subsequent duration of mechanical ventilation, compared to standard modalities like the Pressure Support Ventilation (PSV) . Moreover, NAVA allows the evaluation of the diaphragm electrical activity (EAdi), an index of diaphragmatic neural respiratory drive. However, no study has compared TFic values during PSV and NAVA modalities in patients with difficult weaning from MV admitted in ICU.
patients who have failed at least one weaning attempt
mechanical ventilation for at least 24 hours
Pregnancy
Obesity (Body Mass Index > 35 kg/m2)
Contraindication to the insert of a nasogastric tube
Neuromuscular diseases
Critically ill patients on mechanical ventilation (MV) for at least 24 hours, who have failed at least one weaning attempt, hospitalized at the Intensive Care Unit of Fondazione Policlinico Universitario A. Gemelli IRCCS.
Case-crossover
Prospective
difficult weaning patients
Other interventionintercostal thickening fraction values during PSV and NAVA modalities in patients with difficult weaning from MV admitted in ICU.
intercostal thickening fraction
intercostal thickening fraction values during PSV and NAVA
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