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Neurally adjusted ventilatory assist

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Neurally Adjusted Ventilatory Assist (NAVA) - is a mode of mechanical ventilation. NAVA delivers assistance in proportion to and in synchrony with the patient's respiratory efforts, as reflected by the Edi signal. This signal represents the electrical activity of the diaphragm, the body's principal breathing muscle[1].

The act of taking a breath is controlled by the respiratory center of the brain, which decides the characteristics of each breath, timing and size. The respiratory center sends a signal along the phrenic nerve, excites the diaphragm muscle cells, leading to muscle contraction and descent of the diaphragm dome. As a result, the pressure in the airway drops, causing an inflow of air into the lungs[2].

With NAVA, the electrical activity of the diaphragm (Edi) is captured, fed to the ventilator and used to assist the patient's breathing in synchrony with and in proportion to the patients own efforts, regardless of patient category or size. As the work of the ventilator and the diaphragm is controlled by the same signal, coupling between the diaphragm and the SERVO-i ventilator is synchronized simultaneously[3] [4] [5] [6] [7] [8] [9] [10] [11].

References

  1. ^ MacIntyre N (2010). "Talk to me! Toward better patient-ventilator communication". Critical Care Medicine. 38 (2): 714–5. doi:10.1097/CCM.0b013e3181c0ddef. PMID 20083941. {{cite journal}}: Unknown parameter |month= ignored (help)
  2. ^ Brochard LJ (2009). "Tidal volume during acute lung injury: let the patient choose?". Intensive Care Medicine. 35 (11): 1830–2. doi:10.1007/s00134-009-1632-z. PMID 19760207. {{cite journal}}: Unknown parameter |month= ignored (help)
  3. ^ MAQUET, NAVA, brochure, 2010 MAQUET Critical Care AB, Order No MX-0616
  4. ^ Navalesi P, Colombo D, Della Corte F (2010). "NAVA ventilation". Minerva Anestesiologica. 76 (5): 346–52. PMID 20395897. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  5. ^ Schmidt M, Demoule A, Cracco C; et al. (2010). "Neurally adjusted ventilatory assist increases respiratory variability and complexity in acute respiratory failure". Anesthesiology. 112 (3): 670–81. doi:10.1097/ALN.0b013e3181cea375. PMID 20179505. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  6. ^ Spahija J, de Marchie M, Albert M; et al. (2010). "Patient-ventilator interaction during pressure support ventilation and neurally adjusted ventilatory assist". Critical Care Medicine. 38 (2): 518–26. doi:10.1097/CCM.0b013e3181cb0d7b. PMID 20083921. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  7. ^ Saddy F, Thompson A, Gago F; et al. (2009). "Comparison of energy expenditure between neurally adjusted ventilatory assist and pressure support ventilation in COPD patients". American Journal of Respiratory and Critical Care Medicine. 179 (1): A3817. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  8. ^ Conti G, Costa R (2010). "Technological development in mechanical ventilation". Current Opinion in Critical Care. 16 (1): 26–33. doi:10.1097/MCC.0b013e328334b1e3. PMID 19956072. {{cite journal}}: Unknown parameter |month= ignored (help)
  9. ^ Wu XY, Huang YZ, Yang Y, Liu SQ, Liu HG, Qiu HB (2009). "[Effects of neurally adjusted ventilatory assist on patient-ventilator synchrony in patients with acute respiratory distress syndrome]". Zhonghua Jie He He Hu Xi Za Zhi (in Chinese). 32 (7): 508–12. PMID 19954004. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  10. ^ Del Sorbo L, Slutsky AS (2010). "Ventilatory support for acute respiratory failure: new and ongoing pathophysiological, diagnostic and therapeutic developments". Current Opinion in Critical Care. 16 (1): 1–7. doi:10.1097/MCC.0b013e32833500bc. PMID 19952735. {{cite journal}}: Unknown parameter |month= ignored (help)
  11. ^ Campoccia Jalde F, Almadhoob AR, Beck J, Slutsky AS, Dunn MS, Sinderby C (2010). "Neurally adjusted ventilatory assist and pressure support ventilation in small species and the impact of instrumental dead space". Neonatology. 97 (3): 279–85. doi:10.1159/000255167. PMID 19887857.{{cite journal}}: CS1 maint: multiple names: authors list (link)
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