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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2013 August;79(8):915-25

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: English

Neurally adjusted ventilatory assist in non-invasive ventilation

Sinderby C. 1, 2, Beck J. 1, 3

1 Department of Critical Care, Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael’s Hospital; St. Michael’s Hospital, Toronto, Ontario, Canada; 2 Department of Pediatrics, University of Toronto, Toronto, Canada; 3 Department of Medicine and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada


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This manuscript describes the motivation for developing neurally adjusted ventilatory assist (NAVA) and its subsequent use with a non-invasive interface. The challenges with conventional, pneumatically controlled non-invasive modes are briefly described, followed by a mini-review on the upper airways and the diaphragm electrical activity (EAdi) signal. The bulk of the review focuses on the importance and use of monitoring the EAdi during non-invasive ventilation, and a report of the recent experimental and clinical findings with NAVA during non-invasive ventilation. In summary, non-invasive NAVA provides a truly synchronized mode of non-invasive ventilation, both in time and in level of assist. Along with EAdi monitoring, NAVA can increase the confidence to treat respiratory failure non-invasively.

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sinderbyc@smh.ca