[Neurally adjusted ventilatory assist: a revolution of mechanical ventilation?].
Neurally adjusted ventilatory assist or NAVA is a new assisted ventilatory mode which, in comparison with pressure support, leads to improved patient-ventilator synchrony and a more variable ventilatory pattern. It also improves arterial oxygenation. With NAVA, the electrical activity of the diaphragm is recorded through a nasogastric tube equipped with electrodes. This electrical activity is then used to pilot the ventilator. With NAVA, the patient's respiratory pattern controls the ventilator's timing of triggering and cycling as well as the magnitude of pressurization, which is proportional to inspiratory demand. The effect of NAVA on patient outcome remains to be determined through well-designed prospective studies.
Service de médecine intensive adulte et Centre des brûles, CHUV, 1011 Lausanne. lise.piquilloud@chuv.ch
Lise
L
Piquilloud
Philippe
P
Jolliet
Didier
D
Tassaux
D003964:Diaphragm / Q000294:innervation* / Q000503:physiopathology; D004582:Electronics, Medical / Q000639:trends; D006801:Humans; D011175:Positive-Pressure Respiration / Q000295:instrumentation; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods / Q000639:trends; D012128:Respiratory Distress Syndrome / Q000503:physiopathology / Q000628:therapy*; D056152:Respiratory Rate; D013990:Tidal Volume; D012122:Ventilators, Mechanical / Q000639:trends