Daniel Hadfield

Daniel Hadfield

Research Fellowship: Allied Health  Professionals
Project: The use of neurally adjusted ventilatory assist in the adult ICU
Supervisors: Dr Gerrard Rafferty, Dr Phil Hopkins, Dr Nicholas Hart

Profile

I successfully attained my fellowship in 2012. This provided me with one year of salary, consumables, training fees and access to expert help. During my fellowship year I registered successfully for my PhD with King’s College London. I also gained formal methodology training, was able to develop my research protocol and submit ethics applications for my studies. This enabled me to commence study recruitment and submit  further fellowship applications.

I was successful with both a charity application and with an application to the NIHR/HEE CAT fellowship scheme in 2014. Without my fellowship,  I certainly could not have achieved this. I now have the support that I need and I hope to complete my main feasibility trial in 2016 and my PhD in 2018.

Research Summary

Invasive ventilation is a key ICU treatment and a key nursing responsibility. More than 1300 patients per year in our ICU alone receive this treatment. It can be life-saving, but prolonged ventilation is common, and is associated with increased morbidity and mortality and with long term physical and cognitive problems. The problem is set to get worse with increasing admissions, age and comorbidities.

Neurally Adjusted Ventilatory Assist (NAVA) addresses these issues by allowing the patient’s neural signals – diaphragmatic signals detected via a feeding catheter – to control the mechanical ventilator, thereby using the patient’s own complex feedback mechanisms to provide synchronous and adaptive support.

As yet there are no prospective, randomised trials assessing the effect on duration of ventilation or sedation. There is an ever growing international recognition of the need for such research. My research is now focused upon conducting an interventional feasibility stage study, randomising high risk patients to standard care or NAVA, to inform a later randomised controlled trial.