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VOLUME 20 , ISSUE 6 ( 2016 ) > List of Articles


Neurally adjusted ventilation assist in weaning difficulty: First case report from India

Milind Baldi

Keywords : Mechanical ventilation, neurally adjusted ventilatory assist, weaning failure

Citation Information : Baldi M. Neurally adjusted ventilation assist in weaning difficulty: First case report from India. Indian J Crit Care Med 2016; 20 (6):364-367.

DOI: 10.4103/0972-5229.183896

License: CC BY-ND 3.0

Published Online: 01-01-2014

Copyright Statement:  Copyright © 2016; The Author(s).


Invasive mechanical ventilation is an integral component in the management of critically ill patients. In certain situations, liberation from mechanical ventilation becomes difficult resulting in prolonged ventilation. Patient-ventilator dyssynchrony is a frequently encountered reason for difficult weaning. Neurally adjusted ventilatory assist (NAVA) is a novel mode of ventilation that utilizes the electrical activity of diaphragm to pick up respiratory signals and delivers assistance in proportion to the ventilatory requirement of a patient. It may, therefore, be associated with a better patient-ventilator synchrony thereby facilitating weaning. Herein, we report the first case from India describing the use of NAVA in successfully weaning a patient with difficult weaning.

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  1. Pierson DJ. Patient-ventilator interaction. Respir Care 2011;56:214-28.
  2. Sassoon CS, Foster GT. Patient-ventilator asynchrony. Curr Opin Crit Care 2001;7:28-33.
  3. Thille AW, Rodriguez P, Cabello B, Lellouche F, Brochard L. Patient-ventilator asynchrony during assisted mechanical ventilation. Intensive Care Med 2006;32:1515-22.
  4. Sinderby C, Navalesi P, Beck J, Skrobik Y, Comtois N, Friberg S, et al. Neural control of mechanical ventilation in respiratory failure. Nat Med 1999;5:1433-6.
  5. Yonis H, Crognier L, Conil JM, Serres I, Rouget A, Virtos M, et al. Patient-ventilator synchrony in neurally adjusted ventilatory assist (NAVA) and pressure support ventilation (PSV): A prospective observational study. BMC Anesthesiol 2015;15:117.
  6. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. N Engl J Med 2000;342:1301-8.
  7. Terzi N, Piquilloud L, Rozé H, Mercat A, Lofaso F, Delisle S, et al. Clinical review: Update on neurally adjusted ventilatory assist – Report of a round-table conference. Crit Care 2012;16:225.
  8. Gnanapandithan K, Agarwal R, Aggarwal AN, Gupta D. Weaning by gradual pressure support (PS) reduction without an initial spontaneous breathing trial (SBT) versus PS-supported SBT: A pilot study. Rev Port Pneumol 2011;17:244-52.
  9. Sehgal IS, Dhooria S, Aggarwal AN, Agarwal R. Role of noninvasive mechanical ventilation in difficult weaning. In: Esquinas MA, editor. Noninvasive Mechanical Ventilation: Theory, Equipment, and Clinical Applications. Cham: Springer International Publishing; 2016. p. 457-72.
  10. Piquilloud L, Vignaux L, Bialais E, Roeseler J, Sottiaux T, Laterre PF, et al. Neurally adjusted ventilatory assist improves patient-ventilator interaction. Intensive Care Med 2011;37:263-71.
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