Neurally Adjusted Ventilatory Assist Versus Pressure Support Ventilation: A Comprehensive Review

Mechanical ventilation serves as crucial life support for critically ill patients. Although it is life-saving prolonged ventilation carries risks and complications like barotrauma, Ventilator-associated pneumonia, sepsis, and many others. Optimizing patient-ventilator interactions and facilitating e...

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Bibliographic Details
Published in:Journal of intensive care medicine 2024-12, Vol.39 (12), p.1194-1203
Main Authors: Mandyam, Saikiran, Qureshi, Muhammad, Katamreddy, Yamini, Parghi, Devam, Patel, Priyanka, Patel, Vidhi, Anshul, Fnu
Format: Article
Language:English
Subjects:
Critical Care - methods
Critical Illness - therapy
Humans
Intensive Care Units
Interactive Ventilatory Support - methods
Positive-Pressure Respiration - methods
Respiration, Artificial - methods
Respiratory Insufficiency - therapy
Ventilator Weaning - methods
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Summary:Mechanical ventilation serves as crucial life support for critically ill patients. Although it is life-saving prolonged ventilation carries risks and complications like barotrauma, Ventilator-associated pneumonia, sepsis, and many others. Optimizing patient-ventilator interactions and facilitating early weaning is necessary for improved intensive care unit (ICU) outcomes. Traditionally Pressure support ventilation (PSV) mode is widely used for weaning patients who are intubated and mechanically ventilated. Neurally adjusted ventilatory assist (NAVA) mode of the ventilator is an emerging ventilator mode that delivers pressure depending on the patient's respiratory drive, which in turn prevents over-inflation and improves the patient's ventilator interactions. Our article revises and compares the effectiveness of NAVA compared to PSV ventilation under different contexts. Overall we conclude that NAVA level of ventilation can be safely administered in a patient with acute respiratory failure, provided diaphragmatic paralysis is not considered. NAVA improves asynchrony index, wean-off time, and sleep quality and is associated with increased ventilator-free days. These results are based on small-scale studies with low power, and further studies are warranted in large-scale cohorts with more diverse populations to confirm these results.
ISSN:0885-0666
1525-1489
1525-1489
DOI:10.1177/08850666231212807