Related Experiment Video
Updated: May 28, 2026

Non-Intubated Video-Assisted Thoracoscopic Surgery
Published on: May 26, 2023
Neurally adjusted ventilatory assist mode used in congenital diaphragmatic hernia
Naveed-ur-Rehman Durrani1, Fares Chedid, Aiman Rahmani
1Department of Paediatrics, Tawam Hospital in Association with Johns Hopkins Medicine, Al Ain, Abu Dhabi, United Arab Emirates. rehman_naveed@hotmail.com
Abstract:
A term baby with congenital diaphragmatic hernia (CDH) underwent surgical repair on the second day of life. Postoperatively; the oxygenation index increased to 85 despite high pressure ventilation with HFOV (high frequency oscillator ventilation) and inhaled nitric oxide therapy. Oxygenation index above 70 carries a mortality rate of 94% and merits starting extracorporeal membrane oxygenation (not available in the UAE). A trial of neurally adjusted ventilatory assist (NAVA) on the 10th postoperative day was followed by a reduction of oxygenation index to 15 and marked improvement of the clinical parameters. The EAdi (electrical activity of diaphragm) signal was relatively weak (± 5 μvolt) requiring augmentation with a high NAVA level (3 - 3.5). The patient was successfully extubated after 3 weeks.
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