Skip to main content


We're creating a new version of this page. See preview

Volume 3 Supplement 1


  • Poster presentation
  • Open Access

Comparison of neurally adjusted ventilatory assist and pressure support ventilation during the early phase of weaning from mechanical ventilation - a randomised controlled study

  • 1, 2,
  • 3,
  • 1, 2,
  • 4,
  • 5,
  • 6,
  • 7,
  • 8,
  • 9,
  • 10,
  • 11,
  • 12 and
  • 1, 2
Intensive Care Medicine Experimental20153 (Suppl 1) :A410

  • Published:


  • Mechanical Ventilation
  • Respiratory Failure
  • Tidal Volume
  • Hospital Mortality
  • Acute Respiratory Failure


Neurally adjust ventilatory assist (NAVA) is a ventilatory mode that tailors the level of assistance delivered by the ventilator to the electromyographic activity of the diaphragm. Physiological studies have demonstrated the benefit of NAVA on patient ventilator interactions and prevention of lung over inflation. However, clinical data are currently lacking.


To compare NAVA and Pressure Support Ventilation (PSV) at the early phase of ventilator weaning in patients recovering from an acute respiratory failure.

Patients and Methods

A multicenter randomized controlled trial of 128 intubated adults (median [IQR] age, 66 [57-77] years) was conducted in 11 intensive care units in France from April 2010 to June 2012. Patients were included as soon as they could tolerate PSV with a PS level ≤30 cmH2O, a PEEP ≤8 cmH2O and a FiO2 ≤50%. Patients were randomly assigned to NAVA (n = 62) or PSV (n = 66). The PS level in the PSV group and the NAVA level in the NAVA group were set to obtain a tidal volume of 6-8 ml/kg. The primary end point was the probability to remain in an assist mode during the entire first 48 hours. Secondary end points were duration of mechanical ventilation and 28 days mortality.


67.2% (n = 45) in the NAVA group vs. 63.3% (n = 44) in the PSV group (p = 0.66).. The time spend in an assist mode during the first 48 hours was 47 [43-48] hours in the NAVA group vs. 47 [40-48] hours in the PSV group (p = 0.55). The asynchrony index was lower in the NAVA group (19.7% vs. 32.6%), so was the prevalence of dyspnea at day-1 (9% vs. 19%). The time to first extubation was 7 [2-10] days in the NAVA group vs. 7 [2-10] days in the PSV group (p = 0.78). The hospital mortality rate in the NAVA group was 14.5% (n = 9) vs. 21.2% (n = 14) in the PSV group (p = 0.2). NAVA and PSV were associated to similar oxygenation. NAVA was not associated with any adverse event.


NAVA can be applied efficiently in a clinical setting and improves patient ventilator interaction. However, NAVA does not increase the probability to remain in an assisted mode nor it reduces hospital mortality.

Authors’ Affiliations

Groupe Hospitalier Pitié-Salpêtrière, Paris, France
UMRS 1158, INSERM and Pierre and Marie Curie University, Paris, France
Hôpital Dupuytren, Limoges, France
Hôpital D'Estaing, Clermont-Ferrand, France
CHU Côte de Nacre, Caen, France
CHRU, Angers, France
Centre Hospitalier Lyon-Sud, Lyon, France
Hôpital de la Croix Rousse, Lyon, France
CHU de Bordeaux, Pessac, France
Hopital Pellegrin - CHU de Bordeaux, Bordeaux, France
Hôpital de l'Archet, Nice, France
Hôpital Saint-Eloi, Montpellier, France


© Demoule et al.; 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.