title: Non-invasive ventilation with neurally adjusted ventilatory assist in newborns.
abstract: Neurally adjusted ventilatory assist (NAVA) is a mode of ventilation in which both the timing and degree of ventilatory assist are controlled by the patient. Since NAVA uses the diaphragm electrical activity (Edi) as the controller signal, it is possible to deliver synchronized non-invasive NAVA (NIV-NAVA) regardless of leaks and to monitor continuously patient respiratory pattern and drive. Advantages of NIV-NAVA over conventional modes include improved patient-ventilator interaction, reliable respiratory monitoring and self-regulation of respiratory support. In theory, these characteristics make NIV-NAVA an ideal mode to provide effective, appropriate non-invasive support to newborns with respiratory insufficiency. NIV-NAVA has been successfully used clinically in neonates as a mode of ventilation to prevent intubation, to allow early extubation, and as a novel way to deliver nasal continuous positive airway pressure. The use of NAVA in neonates is described with an emphasis on studies and clinical experience with NIV-NAVA.
authors.affiliation: Neonatal Intensive Care Unit, Promedica Toledo Children's Hospital, Toledo, OH, USA; University of Toledo, Toledo, OH, USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Stein
authors.affiliation: Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Institute for Biomedical Engineering and Science Technology (iBEST), Ryerson University and St Michael's Hospital, Toronto, Ontario, Canada; Keenan Research Centre for Biomedical Science, St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Beck
authors.affiliation: Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Department of Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Electronic address: michael.dunn@sunnybrook.ca.
authors.forename: Michael
authors.initials: M
authors.lastname: Dunn
mesh_terms: D006801:Humans; D007231:Infant, Newborn; D059725:Interactive Ventilatory Support / Q000379:methods*; D063087:Noninvasive Ventilation / Q000379:methods*; D012131:Respiratory Insufficiency / Q000628:therapy*
keywords: Diaphragm; Diaphragm electrical activity; Interactive ventilatory support; Neurally adjusted ventilatory assist; Newborn infant; Non-invasive ventilation; Premature infant