title: Synchronized mechanical ventilation using electrical activity of the diaphragm in neonates.
abstract: The electrical activity of the diaphragm (Edi) is measured by a specialized nasogastric/orogastric tube positioned in the esophagus at the level of the crural diaphragm. Neurally adjusted ventilatory assist (NAVA) uses the Edi signal as a neural trigger and intrabreath controller to synchronize mechanical ventilatory breaths with the patient's respiratory drive and to proportionally support the patient's respiratory efforts on a breath-by-breath basis. NAVA improves patient-ventilator interaction and synchrony even in the presence of large air leaks, and might therefore be an optimal option for noninvasive ventilation in neonates.
authors.affiliation: Department of Neonatology, Toledo Children's Hospital, 2142 North Cove Boulevard, Toledo, OH 43606, USA. Howardstein@bex.net
authors.forename: Howard
authors.initials: H
authors.lastname: Stein
authors.forename: Kimberly
authors.initials: K
authors.lastname: Firestone
authors.forename: Peter C
authors.initials: PC
authors.lastname: Rimensberger
mesh_terms: D003964:Diaphragm / Q000294:innervation*; D004576:Electromyography; D006801:Humans; D007231:Infant, Newborn; D059725:Interactive Ventilatory Support / Q000379:methods*; D007441:Intubation, Gastrointestinal; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*; D015656:Respiratory Mechanics