2014
DOI: 10.1159/000367886
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Neurally Adjusted Ventilatory Assist in Preterm Neonates with Acute Respiratory Failure

Abstract: Background: Neurally adjusted ventilatory assist (NAVA) is a novel mode of ventilation that has been demonstrated to improve infant-ventilator interaction, compared to the conventional modes in retrospective and short-term studies. Objectives: To prospectively evaluate the physiologic effects of NAVA in comparison with pressure-regulated volume control (PRVC) in two nonrandomized 12-hour periods. Methods: We studied 14 consecutive intubated preterm neonates receiving mechanical ventilation for acute respirator… Show more

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Cited by 56 publications
(51 citation statements)
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“…This report is the first to assess the long‐term respiratory outcomes in ELBWI who received NAVA compared with CMV (SIMV+PS and/or HFO). Although NAVA compared with SIMV+PS or PSV has previously been shown to significantly decrease the peak pressure and work of breathing, a reduced prevalence of BPD has not been found in any studies. A low peak pressure can suppress the evolution of BPD due to the prevention of ventilator‐induced lung injury.…”
Section: Discussionmentioning
confidence: 68%
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“…This report is the first to assess the long‐term respiratory outcomes in ELBWI who received NAVA compared with CMV (SIMV+PS and/or HFO). Although NAVA compared with SIMV+PS or PSV has previously been shown to significantly decrease the peak pressure and work of breathing, a reduced prevalence of BPD has not been found in any studies. A low peak pressure can suppress the evolution of BPD due to the prevention of ventilator‐induced lung injury.…”
Section: Discussionmentioning
confidence: 68%
“…It has also been shown to improve synchronicity and allow for an improvement in infant comfort scale, but these reports were limited to short‐term outcomes. No report has evaluated the long‐term outcomes of NAVA, such as the incidence of BPD, and few reports have evaluated whether NAVA could reduce the clinical use of sedation …”
mentioning
confidence: 99%
“…During NAVA, the pressure applied is proportional to the electrical activity of the diaphragm. In a cross-over study of 14 preterm infants [3], asynchrony was significantly lower during 12 h on NAVA than during 12 h on pressure regulated, volume controlled ventilation. In addition, amongst ten infants recovering from severe acute respiratory distress syndrome, oxygenation was superior after 8 h of NAVA compared to after 8 h of pressure support ventilation (PSV) [5].…”
Section: Discussionmentioning
confidence: 86%
“…In addition, amongst ten infants recovering from severe acute respiratory distress syndrome, oxygenation was superior after 8 h of NAVA compared to after 8 h of pressure support ventilation (PSV) [5]. These data [1,3,5] and the results currently reported suggest ventilation modes which apply airway pressure in proportion to the infant's respiratory effort throughout inspiration may be superior to those modes in which synchronisation is only at the start of inspiration (ACV) or the start and end of inspiration (pressure support ventilation).…”
Section: Discussionmentioning
confidence: 87%
“…Peak inspiratory pressures were between 15 and 20 cmH 2 O. Figure 1 shows the mean Edi level and peak pressure: a significant increase in Edi is evident (p<0.001, Student’s t-test); after 96 hours of NAVA, both minimal and maximal Edi levels were in the expected ranges for preterm babies 1. Peak pressure did not significantly change (p=0.51, Student’s t-test).…”
mentioning
confidence: 92%