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Updated: Jun 6, 2026
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Measuring Diaphragm Thickness and Function Using Point-of-Care Ultrasound
Published on: November 3, 2023
Comparison of diaphragmatic function between pressure support and NAVA using ultrasonography
Serafeim-Chrysovalantis Kotoulas1, Eleni Soilemezi2, Pinelopi Pisanidou2
1Adult Intensive Care Unit, Hippokration General Hospital, Thessaloniki, Greece.
Respiratory Medicine
|June 4, 2026
Summary
Neurally adjusted ventilatory assist (NAVA) and pressure support (PS) showed no significant differences in diaphragmatic function in critically ill patients. Further research is needed to determine if NAVA offers advantages for mechanical ventilation weaning.
Area of Science:
- Critical Care Medicine
- Respiratory Physiology
- Medical Ultrasonography
Background:
- Mechanical ventilation weaning is challenging, with 20-30% of ICU patients failing.
- Neurally adjusted ventilatory assist (NAVA) potentially improves patient-ventilator synchrony and diaphragmatic efficiency.
- The impact of NAVA on diaphragmatic function and weaning outcomes requires further investigation.
Purpose of the Study:
- To compare diaphragmatic function between NAVA and pressure support (PS) using ultrasonographic indices.
- To assess if NAVA provides superior diaphragmatic measurements predictive of weaning success.
- To test the hypothesis that NAVA yields more favorable outcomes after brief implementation.
Main Methods:
- Prospective study of 19 adult ICU patients with weaning difficulty.
- Comparison of NAVA and PS ventilation modes, with parameters matched for tidal volume and pressure.
- Diaphragmatic ultrasound assessed tissue Doppler parameters and thickening fraction by a blinded operator.
Main Results:
- Analysis of 219 breathing cycles (109 PS, 110 NAVA).
- No significant differences found between NAVA and PS in ventilatory parameters.
- No significant differences observed in diaphragmatic electrical activity, tissue Doppler indices, or thickening fraction.
Conclusions:
- This study found no clinically significant differences in diaphragmatic function between NAVA and PS.
- Matched ventilatory parameters did not reveal advantages for NAVA in this cohort.
- Larger studies with extended NAVA exposure are necessary to clarify its potential benefits in weaning.
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