ECMO-/ECLS

 Fewer sedation days.
 Fewer ventilation days.
 Aids in weaning to extubation.
 When not to use NAVA:
 Patient is not spontaneously breathing (e.g. oversedation, neuromuscular
abnormalities, no neural activity).
 Patient does not have a working diaphragm.
 Equipment Needed:
 Servo-I ventilator with NAVA software.
 Edi catheter:
 Special NG/OG tube, inserted with sterile water – no lubricants or gels.
 20 - 30 minute warmup time once placed.
 Signal
Edi Peak Edi Minimum
Measures electrical of diaphragm Diaphragm at rest
Normal level 1-10 microvolts Normal level 0-2 microvolts
Higher the peak, harder the diaphragm is
working
Increase peep to keep Edi minimum at 0-
2 microvolts
Level is set by respiratory therapist (RT)
Higher the NAVA level set, the more
patient’s work of breathing is off-loaded,
resulting in lower peak value
 Starting NAVA level:
 1 - 2 cm H2O/microvolt
 Use preview screen on ventilator
 Optimal NAVA level is achieved when increase in NAVA level results in minimal
changes in PIP, TV, and Edi peak.
 TV of 4-6 mL/kg at lowest Edi peak.