NAVA-LUS study
Research type
Research Study
Full title
Effect of Neurally adjusted ventilation assist (NAVA) on lung ultrasound scores, diaphragmatic thickness and excursion in extremely premature babies with evolving or established Bronchopulmonary Dysplasia (BPD)
IRAS ID
320870
Contact name
Sandeep Shetty
Contact email
Sponsor organisation
Joint Research & Enterprise Services (JRES)
Duration of Study in the UK
1 years, 4 months, 31 days
Research summary
New modes of ventilation have been developed with the aim of reducing ventilator associated lung injury and improving respiratory outcomes. NAVA is a mode of ventilation that can be used in patients who are invasively or non-invasively ventilated. NAVA uses the electrical activity of the diaphragm (EAdi), captured via a specialised nasogastric tube with miniature electrodes (EAdi catheter), to trigger the Servo-N pneumatic life support ventilator. The EAdi is used to both trigger each inflation and determine the level of support proportional to the infant’s neural drive throughout each inflation. Clinicians set the NAVA level by which the EAdi signal is translated into delivered airway pressure. Since the diaphragm and ventilator work on the same electrical signal, instantaneous mechanical coupling enables breaths to be started earlier in the cycle compared to triggers in standard flow ventilation modes. This is designed to provide more accurate synchronisation with the infant’s respiratory drive, minimising auto or double triggering and avoiding air leaks associated with pressure or flow signals.
NAVA is routinely used as one of ventilation modes as standard care on the neonatal unit at St George's Hospital. The initiation of NAVA ventilation is a clinical decision made by the attending consultant. We propose to study neonates who are born less than 32 weeks as this population is at increased risk of BPD. Our study aims to use lung ultrasound to assess lung recruitment pre and post NAVA initiation. Our primary outcome is to show improved lung ultrasound scores following the initiation of NAVA ventilation. We hope to prove that NAVA achieves better lung recruitment through the use of optimised ventilation and improved synchrony.
REC name
South West - Central Bristol Research Ethics Committee
REC reference
23/SW/0100
Date of REC Opinion
6 Oct 2023
REC opinion
Favourable Opinion