Always in synchrony: In NAVA, the ventilator delivers assist in proportion to patient demand, and the patient and ventilator are always in synchrony. This benefits the patient, as the synchronized respiratory assist enables lower assist levels, and eliminates the mismatch in pneumatic timing of inspiration and expiration, avoiding the risk of missed efforts. NAVA provides a smooth transition to natural breathing.
Edi – the respiratory vital sign: The Edi signal can be used as a diagnostic tool to monitor the electrical activity of the diaphragm (Edi) in any situation or ventilation mode as well as in standby after extubation. This provides useful information on respiratory drive, volume requirements and the effect of the ventilatory settings.
Decision support for intubation or extubation: The Edi signal also indicates patient condition. An increasing Edi may signify increasing weakness or worsening of the patient condition, as objective criteria for intubation decisions. As the patient’s condition improves, the decreasing Edi amplitude and pressure drop is an indicator to consider weaning and extubation.
Decision support for unloading and assist titration: The Edi signal enables clinicians to set the assist level from the ventilator and to optimize unloading. PEEP titrated to the lowest Edi means that work of breathing is minimized. As the patient’s condition improves with NAVA, Edi amplitude decreases, resulting in a reduction in ventilator-delivered pressure.
Patient comfort: With NAVA, the respiratory muscles and the ventilator are driven by the same signal. This synchrony between patient and ventilator may minimize patient discomfort and agitation, promoting spontaneous breathing, providing for improved sleep quality and possibly reduced sedation.
Decreasing the patient’s pressure load and risk of over assist: The use of NAVA helps avoid over- or under assistance of the patient. In an increasing number of clinical studies, NAVA has been associated with lower levels of peak airway pressures, compared to conventional mechanical ventilation with Pressure Support.
In neonatal and pediatric intensive care patient populations, ventilation with NAVA was associated with improved patient-ventilator synchrony and lower peak airway pressure when compared with Pressure Support ventilation.