Comparing changing neurally adjusted ventilatory assist (NAVA) levels in intubated and recently extubated neonates

LoVerde, B; Firestone, Kimberly S; Stein, Howard

doi:10.1038/jp.2016.152

Cited by 18 publications

(24 citation statements)

References 11 publications

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“…When the NAVA level was progressively increased, the peak Edi rapidly decreased to low values and seems to settle at NAVA levels above 2.5 cmH 2 O/μV. This decrease in Edi value was accompanied by an increase in the PIP, as previously described by Firestone et al, 2,3 particularly at low values of NAVA level. As underlined by the authors, the Edi peak remained low and unchanged with NAVA levels between 2.5 and 4 cmH 2 O/μV.…”

Section: E T T E R T O T H E E D I T O Rsupporting

confidence: 73%

Neural feedback is effective in preterm infants during neurally adjusted ventilatory assist, when using clinically relevant settings

Bridier

François

Baudin

2019

Pediatric Pulmonology

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Section: E T T E R T O T H E E D I T O Rsupporting

confidence: 73%

Neural feedback is effective in preterm infants during neurally adjusted ventilatory assist, when using clinically relevant settings

Bridier

François

Baudin

2019

Pediatric Pulmonology

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“…Combining these two modes resulted in identical pressures (but halved) and opposite in sign positive pressure NAVA (Brander et al, 2009;Firestone, Fisher, Reddy, White, & Stein, 2015;Lecomte et al, 2009;Takahashi et al, 2014). As previously shown with positive pressure NAVA, in both animals and humans (including premature infants (Firestone et al, 2015;LoVerde, Firestone, & Stein, 2016), the usual physiological response to increasing assist during NAVA is a downregulation of EAdi while the pressure and volume increase initially, followed by a plateau (sometimes referred to as an "adequate NAVA level") where the pressure/tidal volume are intrinsically limited, despite further increases in the NAVA level. This is in contrast to increasing levels of pressure support ventilation, where the targeted pressure (and volume) increase as directed, despite the downregulation of EAdi (Beck et al, 2007).…”

Section: Cnava P− Titrationsmentioning

confidence: 53%

Feasibility of neurally synchronized and proportional negative pressure ventilation in a small animal model

et al. 2020

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“…Таким образом, NAVA обладает самым быстрым и чувстви-тельным триггером, который начинает поддержку вдоха одновременно с началом сокращения дыхательных мышц пациента. При этом сигнал дыхательного центра распознается аппаратом ИВЛ даже в случае минимального сокращения дыхательной мускулатуры [12,13].…”

Section: Discussionunclassified

The using of a neurally adjusted ventilatory assist in premature infants. Article

Anuriev

Горбачев

Anurieva

et al. 2020

Annals of Critical Care

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Introduction. The problem of choosing an adequate mode and parameters of mechanical ventilation (MV) in premature infants remains extremely important in neonatology. Objectives. To assess the effect of nerve-regulated MV on the gas composition of the blood, the concentration of malondialdehyde (MDA) and glutathione in premature infants. Materials and methods. The study included 46 premature infants who underwent MV from birth. The gestational age of children was 25-32 weeks, birth weight - 520-1100 grams. Two study groups were formed. The first group consisted of newborns with respiratory support in the Synchronized Intermittent Mandatory Ventilation (SIMV), the second group consisted of children who underwent Neurally Adjusted Ventilatory Assist (NAVA).At birth and during the first three days, the parameters of the gas composition of venous blood are measured: pH, pCO2, pO2, BE; lactate level. Concentrations of MDA and glutathione determine the first and seventh days of life. Results. In children of the first group, hypocapnia was observed during the first three days of life, while the minimum level of partial pressure of carbon dioxide (pCO2) was observed on the first day and amounted to 32.0 (24.9; 37.8) mm Hg. In patients of the second group, pCO2 indices were close to the reference ones and amounted to 36.0 (32.5; 42.2) mm Hg (p = 0.01).Indicators of excess base (BE) were reduced in patients in both groups and on the third day amounted to -6.4 (-7.4;-5.2) mmol/l in children of the first group and -4.7 (-6.0;-3.1) mmol/l in children of the second group (p = 0.02). No statistically significant differences in the partial pressure of oxygen (pO2), lactate, and glutathione were observed. Values of MDA were increased in patients of the first and second groups, however, a decrease in its concentration was observed in the dynamics in both groups. On the 7th day, in patients of the first group, the concentration of malondialdehyde decreased from 13.4 nmol/l to 12.0 nmol/l. In patients of the second group, its indices decreased twofold from the initial ones and amounted to 6.3 (5.4; 7.4) nmol/l (p = 0.01). Conclusion.The use of NAVA ventilation in premature infants ensures a constant gas composition of the blood, and also prevents the activation of lipid peroxidation resulting from hypoxia.

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Comparing changing neurally adjusted ventilatory assist (NAVA) levels in intubated and recently extubated neonates

Abstract: Neonates demonstrated an increase in BrP, higher PIP and Edi when extubated from NAVA to NIV NAVA. This is most likely owing to the inefficiencies of NIV ventilation and suggests that neonates require a higher NAVA level when transitioning from NAVA to NIV NAVA.

Cited by 18 publications

References 11 publications

Neural feedback is effective in preterm infants during neurally adjusted ventilatory assist, when using clinically relevant settings

Neural feedback is effective in preterm infants during neurally adjusted ventilatory assist, when using clinically relevant settings

Feasibility of neurally synchronized and proportional negative pressure ventilation in a small animal model

The using of a neurally adjusted ventilatory assist in premature infants. Article

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