RT adjusts levels and follows trends to achieve optimal level.
With NAVA, one may see:
Increase in PIP
Increase in respiratory rate (as breaths are initiated by patient)
Increase in PEEP
Back-up modes that must be set:
Pressure support – this mode is activated when patient stops using diaphragm
but is still able to trigger flow or pressure.
Pressure control volume ventilation is triggered when patient is apneic.
Weaning NAVA
Patient Controlled Provider Controlled
Patient will automatically self-wean Go slow – allow time for diaphragm to
adjust and strengthen
Will see decreasing Edi with unchanged
tidal volume (diaphragm performance has
improved)
Changes are made in 0.1 to 0.2 microvolt
increments
PIPs will be lower
If NAVA level too low, will see:
Widely fluctuating Edi signals and peak pressures
Increased need for sedation
Smaller tidal volumes
Increased oxygen requirement
Patient may appear air hungry
References:
Materials provided by Khris O’Brien, RRTRespiratory Care, Children’s Hospital of Wisconsin-NPS, Clinical Program Coordinator,