title: Neurally adjusted ventilatory assist: assessing the comfort and feasibility of use in neonates and children.
abstract: OBJECTIVE
  To evaluate the practical feasibility for nurses working with neurally adjusted ventilatory assist (NAVA) and assess patient comfort and safety when NAVA is initiated.
  
  
  BACKGROUND
  NAVA is a relatively new mode of ventilation. Its application in neonates and children has been widely documented. However, its practical feasibility from a nursing point of view as well as its safety and comfort in these populations compared with conventional modes of ventilation has not been described.
  
  
  METHODS
  A prospective, observational crossover pilot study.
  
  
  METHODS
  NAVA was compared with the conventional mode of ventilation for 3 h each, and practical feasibility, patient comfort level and safety were assessed.
  
  
  RESULTS
  Twenty-one neonates and children were enrolled into the study. There were no reported adverse events. In most patients, the NAVA catheter was placed too shallow, as measured by the distances from the nose, ear, xiphisternum (NEX) method, according to the manufacturer's instructions. Accurate placement was confirmed by visual inspection of the NAVA positioning window. Patients' comfort did not differ between the conventional mode and NAVA.
  
  
  CONCLUSIONS
  NAVA is feasible, once an accurate signal of the electrical activity of the diaphragm is achieved and seems safe and well tolerated in both neonates and children. Nurses need to gain experience in placing the NAVA catheter and practical recommendations are given.
  
  
  CONCLUSIONS
  NAVA is a promising new mode of ventilation. This article contributes to an increasing body of evidence that NAVA is feasible in neonates and children. There are practical considerations when NAVA is applied in these patient-groups.
authors: Intensive Care, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands. a.duyndam@erasmusmc.nl
authors: Anita
authors: A
authors: Duyndam
authors: Bas S P
authors: BS
authors: Bol
authors: André
authors: A
authors: Kroon
authors: Dick
authors: D
authors: Tibboel
authors: Erwin
authors: E
authors: Ista
mesh_terms: D002648:Child; D016292:Procedural Sedation; D018592:Cross-Over Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D059725:Interactive Ventilatory Support / Q000451:nursing; D008297:Male; D061214:Patient Safety; D010865:Pilot Projects; D011446:Prospective Studies