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Neonatal, cardiac and pediatric intensive care units (ICUs) frequently use the neurally adjusted ventilatory assist (NAVA) mode of ventilation, which has been shown to improve patient-ventilator synchrony and decrease work of breathing as it uses neural impulse to guide patient and ventilator breaths. We reviewed uses of NAVA as the mode of ventilation and oxygenation in pediatric (P)ICU and cardiac (C)ICU patients. We found that NAVA mode improves patient-ventilator interaction by improving synchrony and thus decreasing work of breathing. This eventually improved all aspects of critical care, as demonstrated by decreased need for sedation, improvement in hemodynamics, improvement in patient comfort, decreased days on ventilator, decreased days in ICU and decreased hospital length of stay. Additional studies need to be done in order to help NAVA technology become a primary mode of ventilation in PICU and CICU. Further studies are also needed to evaluate the successful use of noninvasive-NAVA as a means of preventing endotracheal intubation or to allow early extubation in our population.

Neurally Adjusted Ventilatory Assist Mode in Pediatric Intensive Care Unit and Pediatric Cardiac Care Unit