Effects of Different Ventilation Modes on Ventilator-Induced Diaphragm Dysfunction

DU Wei; ZHANG Cheng; WANG Xiaosong

doi:10.3639/j.issn.2095-3097.2025.07.015

Abstract：Objective To compare the effects of different ventilation modes on ventilator-induced diaphragm dys-function(VIDD).Methods Ninety patients undergoing mechanical ventilation at the Second Affiliated Hospital of Guizhou University of Chinese Medicine from January 2022 to January 2024 were enrolled and randomly divided into three groups(n=30 each)using a random number table.The groups received respectively:neurally adjusted ventilatory assist(NAVA),synchro-nized intermittent mandatory ventilation(SIMV),and pressure support ventilation(PSV),designated as NAVA,SIMV,and PSV groups.Comparisons included patient-ventilator synchronization,oxidative stress markers,diaphragm function,mechanical ventilation parameters,weaning success rate,and complications.Results The inspiratory trigger delay and inspiratory/expi-ratory switching delay in the NAVA group were significantly shorter than those in both the SIMV and PSV groups(P<0.05),and shorter in the SIMV group than in the PSV group(P<0.05).The ineffective triggering rate was significantly lower in the NAVA group than in both the SIMV and PSV groups(P<0.05),and lower in the SIMV group than in the PSV group(P<0.05).After treatment,malondialdehyde(MDA)levels significantly decreased(P<0.05)while superoxide dismutase(SOD)and glutathione(GSH)levels significantly increased(P<0.05)in all three groups.Post-treatment intergroup comparisons showed MDA levels in the NAVA group were significantly lower than in both the SIMV and PSV groups(P<0.05),and lower in the SIMV group than in the PSV group(P<0.05);SOD and GSH levels in the NAVA group were significantly higher than in both the SIMV and PSV groups(P<0.05),and higher in the SIMV group than in the PSV group(P<0.05).Diaphragmatic thickening fraction(DTF)and excursion(DE)significantly increased in all groups after treatment(P<0.05),with the NAVA group showing significantly higher values than both the SIMV and PSV groups(P<0.05),and the SIMV group significantly higher than the PSV group(P<0.05).ICU stay duration and mechanical ventilation time were significantly shorter in the NAVA group than in both the SIMV and PSV groups(P<0.05),and shorter in the SIMV group than in the PSV group(P<0.05).The weaning success rate was significantly higher in the NAVA and SIMV groups than in the PSV group(P<0.05),while the total complication incidence was significantly lower in the NAVA and SIMV groups than in the PSV group(P<0.05).Conclusion The NAVA mode reduces oxidative stress injury,shortens mechanical ventilation duration,achieves higher weaning success with fewer complications,and minimizes dia-phragm dysfunction,outperforming SIMV and PSV modes.