Proportional Assist Ventilation and Neurally Adjusted Ventilatory Assist

Kacmarek, Robert M.

doi:10.4187/respcare.01021

Cited by 81 publications

(56 citation statements)

References 69 publications

(31 reference statements)

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“…The catheter is placed so the electrodes are at the level of the diaphragm. 32,33 When positioned properly, the EAdi signal can accurately and reliably trigger and cycle a positive-pressure breath, independent of air leak. Additionally, the magnitude of the inspiratory pressure assist is a product of the EAdi signal and the pre-set NAVA level.…”

Section: Neurally Adjusted Ventilatory Assistmentioning

confidence: 99%

Mechanical Ventilation of the Premature Neonate

Brown

DiBlasi

2011

Respir Care

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Section: Neurally Adjusted Ventilatory Assistmentioning

confidence: 99%

Mechanical Ventilation of the Premature Neonate

Brown

DiBlasi

2011

Respir Care

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“…60 NAVA has been reported to improve synchrony during NIV when a helmet is used. 25 For PAV, Gay et al 61 reported better patient tolerance with PAV, compared to PSV during NIV.…”

Section: Mode Asynchronymentioning

confidence: 99%

Patient-Ventilator Interaction During Noninvasive Ventilation

Hess

2011

Respir Care

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There is arguably more evidence to support the use of noninvasive ventilation (NIV) than any other practice related to the care of patients with acute respiratory failure. Despite this strong evidence base, NIV seems to be under-utilized and the failure rate (need for intubation) may be as high as 40%. Some of these failures potentially relate to asynchrony, although the relationship between asynchrony and NIV failure has not been well studied. Good NIV tolerance has been associated with success of NIV, and improved comfort has been associated with better synchrony. In one study a high rate of asynchrony occurred in 43% of patients during NIV. Asynchrony is commonly associated with leaks. Thus, reducing the leak related to the interface and using a ventilator with good leak compensation should reduce the rate of asynchrony. Asynchronies can also be related to the underlying disease process. This paper reviews issues related to asynchrony during NIV and suggests strategies that might be used to correct asynchrony when it occurs.

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“…16 Neurally adjusted ventilatory assist (NAVA) operates similarly to PAV. 17 The only difference is that NAVA proportionally unloads the patient's inspiratory work of breathing by applying airway pressure per each microvolt increase in the diaphragmatic electromyographic signal. Overall, the application of ventilatory assistance is the same with PAV or NAVA: The greater the patient effort, the greater the ventilator pressure, and the lower the patient effort the lower the ventilator pressure.…”

Section: See the Original Study On Page 1527mentioning

confidence: 99%