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Online ISSN 1827-1596
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
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.