Respiratory failure & ventilation
Neurally adjusted ventilatory assist in critical care patients with and without obesity: a prospective randomized crossover study
Authors' conclusion
In patients with obesity, NAVA ventilation is feasible and safe, improves patient-ventilator interactions and oxygenation, with an increase ventilatory variability compared to PSV. The effects of NAVA are comparable in patients with and without obesity.
Study context
- Population
- ICU patients on mechanical ventilation, with and without obesityall completed · with 10 · without 11
- Comparison
- Neurally Adjusted Ventilatory Assist (NAVA) vs Pressure Support Ventilation (PSV), in patients with vs without obesity
- Primary endpoint
- Feasibility and safety of NAVA in patients with obesity; patient-ventilator interactions (trigger delay, inspiratory time in excess, rate and type of dyssynchrony)
Methodological detailsprospective, 1790 ± 873 respiratory cycles analysed per patient
- Prospective
- 1790 ± 873 respiratory cycles analysed per patient
Primary result
As reported in the abstract
Patient-ventilator interactions, patients with obesity
| Group | Value | Trigger delay | Inspiratory time in excess | Ineffective efforts | Global dyssynchrony index |
|---|---|---|---|---|---|
| NAVA | median 0 (IQR 0–5) ms | 0 [0-5] ms | 96 [94-102] ms | 0 [0-0.03] events/min | 2.2% [1.1-4.4] |
| PSV | median 106 (IQR 34–125) ms | 106 [34-125] ms | 145 [137-202] ms | 0.33 [0.23-0.37] events/min | 3.7% [2.4-5.6] |
Value
NAVAmedian 0 (IQR 0–5) ms
PSVmedian 106 (IQR 34–125) ms
Trigger delay
NAVA0 [0-5] ms
PSV106 [34-125] ms
Inspiratory time in excess
NAVA96 [94-102] ms
PSV145 [137-202] ms
Ineffective efforts
NAVA0 [0-0.03] events/min
PSV0.33 [0.23-0.37] events/min
Global dyssynchrony index
NAVA2.2% [1.1-4.4]
PSV3.7% [2.4-5.6]
- NAVA vs PSV: P < 0.05
- NAVA vs PSV: P < 0.01
- NAVA vs PSV: P < 0.05
- NAVA vs PSV: P = 0.68 — similar in both modes
Further findings
PaO2/FiO2 ratio, patients with obesity · end of each 30-min period · significantly increased in NAVA
P < 0.05
| Outcome | NAVA | PSV | P value |
|---|---|---|---|
| Tidal volume, patients with obesitySignificantly lower during NAVA | 6.7 (bracketed range 5.9–7.1) mL/kg predicted body weight | 7.2 (bracketed range 6.2–8.2) mL/kg | P < 0.05 |
| Ventilatory variability (mean inspiratory airway pressure), patients with obesity | 16% (bracketed range 11–21) | 4% (bracketed range 2–4) |
Ventilatory variability (mean inspiratory airway pressure), patients with obesity
- Significantly higher with NAVA
Patients without obesity
- Results similar in patients without obesity; obesity factor never significant
Safety
- No adverse event in patients with and without obesity in both modes
Original publication
Neurally adjusted ventilatory assist in critical care patients with and without obesity: a prospective randomized crossover study. Ann Intensive Care. Published 29 August 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →