Synchronized mechanical ventilation using electrical activity of the diaphragm in neonates

Howard Stein; Kimberly Firestone; Peter C Rimensberger

doi:10.1016/j.clp.2012.06.004

Synchronized mechanical ventilation using electrical activity of the diaphragm in neonates

Clin Perinatol. 2012 Sep;39(3):525-42. doi: 10.1016/j.clp.2012.06.004.

Authors

Howard Stein¹, Kimberly Firestone, Peter C Rimensberger

Affiliation

¹ Department of Neonatology, Toledo Children's Hospital, 2142 North Cove Boulevard, Toledo, OH 43606, USA. Howardstein@bex.net

PMID: 22954267
DOI: 10.1016/j.clp.2012.06.004

Abstract

The electrical activity of the diaphragm (Edi) is measured by a specialized nasogastric/orogastric tube positioned in the esophagus at the level of the crural diaphragm. Neurally adjusted ventilatory assist (NAVA) uses the Edi signal as a neural trigger and intrabreath controller to synchronize mechanical ventilatory breaths with the patient's respiratory drive and to proportionally support the patient's respiratory efforts on a breath-by-breath basis. NAVA improves patient-ventilator interaction and synchrony even in the presence of large air leaks, and might therefore be an optimal option for noninvasive ventilation in neonates.

Publication types

Review

MeSH terms

Diaphragm / innervation*
Electromyography
Humans
Infant, Newborn
Interactive Ventilatory Support / methods*
Intubation, Gastrointestinal
Respiratory Distress Syndrome, Newborn / therapy*
Respiratory Mechanics