Neurally adjusted ventilatory assist for neonatal respiratory support

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Neurally adjusted ventilatory assist for neonatal respiratory support

Rossor TE, Hunt KA, Shetty S, Greenough A

Review question: Is neurally adjusted ventilatory assist ventilation (NAVA) a more effective method of supporting the breathing of prematurely born infants than conventional ventilation methods?

Background: Neurally adjusted ventilatory assist involves using the electrical signal from the baby’s main breathing muscles to inform the ventilator as to when the baby is trying to breathe, such that the ventilatory may support the baby’s own efforts. Synchronising the efforts of the infant with the activity of the ventilator may reduce required pressures required, along with damage to the lungs. Using the baby’s own breathing control mechanisms may also reduce fluctuations in carbon dioxide levels in the blood and variations in blood flow to the brain.

Study characteristics: During literature searches completed until March 2017, we found one randomised controlled study that met the inclusion criteria for this review.

Key results: We found one eligible study that was conducted to evaluate the use of NAVA in providing neonatal respiratory support. This study reported no significant differences in outcomes of interest between NAVA and patient-triggered time-cycled pressure-limited ventilation. Well-designed studies are needed to further evaluate the role of this potentially exciting technique in providing breathing support for the neonatal population.

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