This review aims to introduce neurally-adjusted ventilatory assist (NAVA) to readers who do not have experience in using this form of ventilation. We will describe the basic principles and theoretical advantages of NAVA together with our experiences of introducing and using this mode in an intensive care unit.
HarrisonDBradyARowanK. Case mix, outcome and length of stay for admissions to adult general critical care units in England, Wales and Northern Ireland: the Intensive Care National Audit and Research Centre case mix programme database. Crit Care2004;8: R99–R111.
2.
PapazianLForelJMGacouinA. Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med2010;363: 1107–16.
3.
ElyEBakerADunaganD. Effect on the duration of mechanical ventilation of identifying patients capable of breathing spontaneously. N Engl J Med1996;335: 1864–69.
4.
KressJPohlmanAO'ConnorMHallJ. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med2000;342: 1471–77.
5.
GirardTKressJFuchsB. Efficacy and safety of paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awake and Breathing Controlled trial): a randomised controlled trial. Lancet2008;371: 126–34.
6.
VassilakopoulosTPetrofB. Ventilator-induced diaphragmatic dysfunction. Am J Respir Crit Care Med2004;169: 336–41.
7.
HudsonMSmuderANelsonW. Both high level pressure support ventilation and controlled mechanical ventilation induce diaphragmatic dysfunction and atrophy. Crit Care Med2012;40: 1254–60.
8.
SinderbyCNavalesiPBeckJ. Neural control of mechanical ventilation in respiratory failure. Nat Med1999;5: 1433–36.
9.
BeckJGottfriedSNavalesiP. Electrical activity of the diaphragm during pressure support ventilation in acute respiratory failure. Am J Respir Crit Care Med2001;164: 419–24.
10.
BarwingJAmboldMLindenN. Evaluation of the catheter positioning for neurally adjusted ventilatory assist. Intensive Care Med2009;35: 1809–14.
11.
BarwingJPedroniCQuintelMMoererO. Influence of body position, PEEP and intra-abdominal pressure on the catheter positioning for neurally adjusted ventilatory assist. Intensive Care Med2011;37: 2041–45.
12.
SchmidtMDemouleACraccoC. Neurally adjusted ventilatory assist increases respiratory variability and complexity in acute respiratory failure. Anesthesiology2010;112: 670–81.
13.
SpahijaJde MarchieMAlbertM. Patient-ventilator interaction during pressure support ventilation and neurally adjusted ventilation assist. Crit Care Med2010;38: 518–26.
BeckJCampocciaFAlloJ. Improved synchrony and respiratory unloading by neurally adjusted ventilatory assist (NAVA) in lung-injured rabbits. Pediatr Res2007;61: 289–94.
16.
ColomboDCammarotaGBergamaschiV. Physiologic response to varying levels of pressure support and neurally adjusted ventilatory assist in patients with acute respiratory failure. Intensive Care Med2008;34: 2010–18.
17.
BranderLSinderbyCLecomteF. Neurally adjusted ventilatory assist decreases ventilator-induced lung injury and non-pulmonary organ dysfunction in rabbits with acute lung injury. Intensive Care Med2009;35: 1979–89.
18.
LeiterJManningH. The Hering-Breuer reflex, feedback control, and mechanical ventilation: the promise of neurally adjusted ventilatory assist. Crit Care Med2010;38: 1915–16.
19.
PassathCTakalaJTuchschererD. Physiological responses to changing positive end-expiratory pressure during neurally-adjusted ventilatory assist in sedated, critically ill adults. Chest2010;138: 578–87.
20.
TerziNPelieuIGuittetL. Neurally adjusted ventilatory assist in patients recovering spontaneous breathing after acute respiratory distress syndrome: Physiological evaluation. Crit Care Med2010;38: 1830–37.
21.
DoorduinJSinderbyCBeckJ. The calcium sensitizer levosimendan improves human diaphragm function. Am J Respir Crit Care Med2012;185: 90–95.
22.
LiuLLiuHYangY. Neuro-ventilatory efficiency and extubation readiness in critically ill patients. Crit Care2012;16: R143.
23.
TuchschererDZ'GraggenWPassathC. Neurally adjusted ventilatory assist in patients with critical illness polyneuropathy. Intensive Care Med2011;37: 1951–61.
24.
NavalesiPColomboDDella ForteF. NAVA ventilation. Minerva Anaesth2010;76: 346–52.
25.
SinderbyCBeckJ. Neurally adjusted ventilatory assist (NAVA): An update and summary of experiences. Neth J Crit Care2007;11: 243–52.
26.
ChiumelloDPolliFTallariniF. Effect of different cycling-off criteria and positive end-expiratory pressure during pressure support ventilation in patients with chronic obstructive pulmonary disease?Crit Care Med2007; 35: 2547–52.
27.
HadfieldDColoradoLVercueilAHopkinsP. The introduction of neurally adjusted ventilatory assist (NAVA) into a central London teaching hospital and a comparison with conventional pressure support?Intensive Care Med2010; 36: S108.
28.
PatronitiNBellaniGSaccavinoE. Respiratory pattern during neurally adjusted ventilatory assist in acute respiratory failure patients. Intensive Care Med2011;38: 230–39.
29.
AlloJBeckJBranderL. Influence of neurally adjusted ventilatory assist and positive end-expiratory pressure on breathing pattern in rabbits with acute lung injury. Crit Care Med2006;34: 2997–3004.
30.
CoiselYChanquesGJungB. Neurally adjusted ventilatory assist in critically ill postoperative patients: a crossover randomized study. Anesthesiology2010;113: 925–35.
31.
BranderLLeong-PoiHBeckJ. Titration and implementation of neurally adjusted ventilatory assist in critically ill patients. Chest2009;135: 695–703.
32.
BosmaKFerreyraGAmbrogioC. Patient-ventilator interaction and sleep in mechanically ventilated patients: pressure support versus proportional assist ventilation. Crit Care Med2007;35: 1048–54.
33.
CabelloBThilleADrouotX. Sleep quality in mechanically ventilated patients: comparison of three ventilatory modes. Crit Care Med2008;36: 1749–55.
34.
DelisleSOuelletPBellemareP. Sleep quality in mechanically ventilated patients: comparison between NAVA and PSV modes. Ann Intensive Care2011;1: 42–9.
35.
LaghiF. NAVA; brain over machine?Intensive Care Med2008;34: 1966–68.
36.
RozeHRichardJCMercatABrochardL. Recording of possible diaphragm fatigue under neurally adjusted ventilatory assist. Am J Resp Crit Care Med2011;184: 1213–14.
37.
BranderLBeckJSinderbyC. Interpreting success or failure of neurally adjusted ventilatory assist. Am J Resp Crit Care Med2012;185: 1248.
38.
TerziNPiquilloudLRozeH. Clinical review: Update on neurally adjusted ventilatory assist – report of a round-table conference. Crit Care2012;16: 225.
39.
KaragiannidisCLubnowMPhilippA. Autoregulation of ventilation with neurally adjusted ventilatory assist on extracorporeal lung support. Intensive Care Med2010;36: 2038–44.
40.
BeckJWeinbergJHamnegardC. Diaphragmatic function in advanced Duchenne muscle dystrophy. Neuromus Disord2006;16: 161–67.
BarwingJLindenNAmboldM. Neurally-adjusted ventilatory assist vs pressure support ventilation in critically ill patients: an observational study. Acta Anaesthesiol Scand2011;55: 1261–71.
43.
MauriTBellaniGFotiG. Successful use of neurally-adjusted ventilatory assist in patients with extremely low respiratory system compliance undergoing ECMO. Intensive Care Med2011;37: 166–67.
44.
RozéHLafrikhAPerrierV. Daily titration of neurally adjusted ventilatory assist using the diaphragm electrical activity. Intensive Care Med2011;37: 1087–94.
45.
BlackwoodBAlderdiceFBurnsK. Protocolized versus non-protocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients. Cochrane Database Systematic Rev2010;5: CD006904.
46.
BeckJBranderLSlutskyA. Non-invasive neurally-adjusted ventilatory assist in rabbits with acute lung injury. Intensive Care Med2008;34: 316–23.
47.
MoererOBeckJBranderL. Subject-ventilator synchrony during neural versus pneumatically triggered non-invasive helmet ventilation. Intensive Care Med2008;34: 1615–23.
48.
CammarotaGOlivieriCCostaR. Noninvasive ventilation through a helmet in postextubation hypoxemic patients: physiologic comparison between neurally adjusted ventilatory assist and pressure support ventilation. Intensive Care Med2011;37: 1943–50.
49.
BertrandPFutierECoiselY. Neurally adjusted ventilatory assist versus pressure support ventilation for non-invasive ventilation during acute respiratory failure: a cross-over physiological study. Chest2013;143: 30–36.
50.
SchmidtMDresMRauxM. Neurally-adjusted ventilatory assist improves patient-ventilator interaction during post-extubation prophylactic non-invasive ventilation. Crit Care Med2012;40: 1738–44.
