Research: The use of neurally-adjusted ventilatory assist (NAVA) for infants with congenital diaphragmatic hernia (CDH)

J Perinat Med

. 2022 Jul 8.

 doi: 10.1515/jpm-2022-0199. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/35795983/

The use of neurally-adjusted ventilatory assist (NAVA) for infants with congenital diaphragmatic hernia (CDH)

Grace Poole 1Sandeep Shetty 2Anne Greenough 3 4

Affiliations expand

Free article

Abstract

Objectives: Newborns with congenital diaphragmatic hernia (CDH) can have complex respiratory problems which are worsened by ventilatory induced lung injury. Neurally adjusted ventilator assist (NAVA) is a potentially promising ventilation mode for this population, as it can result in improved patient-ventilator interactions and provision of adequate gas exchange at lower airway pressures.

Content: A literature review was undertaken to provide an overview of NAVA and examine its role in the management of infants with CDH.

Summary: NAVA in neonates has been used in CDH infants who were stable on ventilatory support or being weaned from mechanical ventilation and was associated with a reduction in the level of respiratory support.

Outlook: There is, however, limited evidence regarding the efficacy of NAVA in infants with CDH, with only short-term benefits being investigated. A prospective, multicentre study with long term follow-up is required to appropriately assess NAVA in this population.

Keywords: congenital diaphragmatic hernia (CDH); neurally adjusted ventilator assist (NAVA); patient-ventilator synchrony.

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