Neurally adjusted ventilatory assist in infants: A review article

Area of Science:

• Neonatology
• Respiratory Medicine
• Biomedical Engineering

Background:

• Neurally adjusted ventilatory assist (NAVA) and non-invasive NAVA offer synchronized and proportional respiratory support.
• These advanced ventilation modes enhance patient comfort by synchronizing with natural breathing patterns.
• Limited experience with NAVA and NIV-NAVA in Taiwanese neonatal populations necessitates further investigation.

Purpose of the Study:

• To evaluate the efficacy of NAVA in improving synchrony and comfort for ventilated newborns and premature infants.
• To review current literature on the application and benefits of NAVA and NIV-NAVA in neonates.
• To provide guidance on optimizing NAVA/NIV-NAVA settings for premature infants.

Main Methods:

• Literature review of recent studies on NAVA and NIV-NAVA in neonatal respiratory support.
• Analysis of comparative effectiveness against conventional ventilation methods.
• Examination of challenges and potential solutions for NAVA/NIV-NAVA implementation in premature infants.

Main Results:

• NAVA and NIV-NAVA demonstrate potential superiority over traditional ventilation in newborns.
• Treatment failure in premature infants can occur due to issues like insufficient diaphragm electrical activity (EAdi) triggering and apnea.
• Specific titration and setting adjustments are crucial for successful NAVA/NIV-NAVA use in neonates.

Conclusions:

• NAVA and NIV-NAVA offer promising benefits for neonatal respiratory support, enhancing synchrony and comfort.
• Careful consideration of EAdi monitoring and tailored settings is essential to overcome challenges in premature infants.
• EAdi monitoring provides valuable real-time physiological data beyond ventilatory support.