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VOLUME 1 , ISSUE 2 ( July-December, 2012 ) > List of Articles

REVIEW ARTICLE

Monitoring electrical activity of the diaphragm and the ventilation mode NAVA (Neurally Adjusted Ventilatory Assist)

Susan P Pilbeam

Keywords : Neurally adjusted ventilatory assist, ventilation, electromyography, diaphragm

Citation Information : Pilbeam SP. Monitoring electrical activity of the diaphragm and the ventilation mode NAVA (Neurally Adjusted Ventilatory Assist). Indian J Respir Care 2012; 1 (2):112-123.

DOI: 10.5005/ijrc-1-1-112

License: NA

Published Online: 01-12-2022

Copyright Statement:  NA


Abstract

While it is possible to monitor the electrical activity of the heart using an electrocardiogram (ECG), the ability to monitor the electrical activity of the diaphragm (EAdi) in the clinical setting has not been possible until recently. A specialised nasogastric tube is now available which can monitor EAdi in the intensive care units (ICU). The EAdi signal can also be used to control a mechanical ventilator. The mode associated with the EAdi is referred to as neurally adjusted ventilator assist (NAVA). It can be used in spontaneously breathing patients. A NAVA ventilator breath is triggered (beginning of breath), delivered and cycled (end of breath) by the patient’s neural control of breathing. This is markedly different from all other modes of ventilation which rely on a pneumatic trigger (flow or pressure change), and where breath delivery and breath termination are generally determined by how the clinician sets the ventilator’s controls. This article will include a discussion of patient-ventilator asynchrony, monitoring the electric activity of the diaphragm (EAdi) with a specialised catheter and will provide an explanation of how NAVA operates.

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