Patient-Ventilator Synchrony and Tidal Volume Variability using NAVA and Pressure Support Mechanical Ventilation Modes

Neurally Adjusted Ventilatory Assist (NAVA) is a new ventilatory mode in which ventilator settings are adjusted based on the electrical activity detected in the diaphragm (Eadi). This mode offers significant advantages in mechanical ventilation over standard pressure support (PS) modes, since ventilator input is determined directly from patient ventilatory demand. A comparative study of 22 patients undergoing mechanical ventilation in both PS and NAVA modes was conducted, and it was concluded that for a given variability in Eadi, there is greater variability in tidal volume and correlation between the tidal volume and the diaphragmatic electrical activity with NAVA compared to PS. These results are consistent with the improved patient-ventilator synchrony reported in the literature.