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Neurally-adjusted ventilatory assist (NAVA) in children: a systematic review

Jennifer Beck1, Guillaume Emeriaud, Yun Liu

  • 1Department of Pediatrics, University of Toronto, Toronto, Canada - jennifer.beck@rogers.com.

Minerva Anestesiologica
|September 17, 2015
PubMed

Insights

Neurally-adjusted ventilatory assist (NAVA) improves patient-ventilator synchrony in children by using diaphragm electrical activity (Edi). This ventilation method is safe and feasible, enhancing comfort and reducing sedation.

Area of Science:

  • Pediatric critical care
  • Respiratory physiology
  • Mechanical ventilation

Background:

  • Mechanical ventilation in children presents challenges due to small tidal volumes, high respiratory rates, and leaks, impacting synchrony and monitoring.
  • Infant respiratory patterns are highly variable, influenced by reflexes and breathing disorders, complicating ventilator adjustments.

Purpose of the Study:

  • To review the scientific literature on the use of Neurally-adjusted ventilatory assist (NAVA) in pediatric and neonatal populations.
  • To summarize findings on both invasive and non-invasive NAVA (NIV-NAVA) and the role of diaphragm electrical activity (Edi) monitoring.

Main Methods:

  • Literature review of studies involving NAVA and Edi monitoring in children.
  • Synthesis of data from publications on invasive and non-invasive NAVA applications.

Main Results:

  • NAVA and Edi monitoring are demonstrated to be feasible and safe in pediatric patients.
  • NAVA significantly improves patient-ventilator interaction compared to conventional ventilation.
  • NAVA use is associated with lower peak inspiratory pressures.

Conclusions:

  • NAVA offers a synchronized ventilatory support method, adaptable to the variable breathing patterns of children.
  • Evidence suggests NAVA may lead to improved patient comfort, reduced need for sedation, and shorter hospital stays.
Abstract

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