{"id":1386,"date":"2026-03-15T09:47:41","date_gmt":"2026-03-15T09:47:41","guid":{"rendered":"https:\/\/perfusfind.com\/ic\/?p=1386"},"modified":"2026-03-15T09:49:26","modified_gmt":"2026-03-15T09:49:26","slug":"neurally-adjusted-ventilatory-assist-in-critical-care-patients-with-and-without-obesity-a-prospective-randomized-crossover-study-2","status":"publish","type":"post","link":"https:\/\/perfusfind.com\/ic\/index.php\/2026\/03\/15\/neurally-adjusted-ventilatory-assist-in-critical-care-patients-with-and-without-obesity-a-prospective-randomized-crossover-study-2\/","title":{"rendered":"Neurally adjusted ventilatory assist in critical care patients with and without obesity: a prospective randomized crossover study"},"content":{"rendered":"<h3 id=\"ember63\" class=\"ember-view reader-text-block__heading-3\">NAVA vs PSV in Obese ICU Patients: First Evidence of Safety and Benefit<\/h3>\n<p id=\"ember64\" class=\"ember-view reader-text-block__paragraph\"><strong>Abstract:<\/strong> This randomized crossover study is the <strong>first to test Neurally Adjusted Ventilatory Assist (NAVA) in critically ill obese patients<\/strong>. Twenty-one ventilated patients (10 obese, 11 non-obese) underwent 30 minutes of NAVA and PSV each. Researchers assessed safety, patient-ventilator synchrony, oxygenation, and variability.<\/p>\n<hr class=\"reader-divider-block__horizontal-rule\" \/>\n<h3 id=\"ember65\" class=\"ember-view reader-text-block__heading-3\">Key Insights<\/h3>\n<ol>\n<li><strong>Feasibility:<\/strong> NAVA was feasible in <strong>all obese patients<\/strong>\u2014signal acquisition and ventilation were successful.<\/li>\n<li><strong>Triggering:<\/strong> In obese patients, NAVA significantly reduced <strong>trigger delay<\/strong> (0 vs 106 ms) and <strong>inspiratory time in excess<\/strong> (96 vs 145 ms) compared to PSV.<\/li>\n<li><strong>Dyssynchrony:<\/strong> Ineffective efforts were markedly lower with NAVA (0 vs 0.33\/min), although overall dyssynchrony index remained similar due to technical double triggering.<\/li>\n<li><strong>Oxygenation:<\/strong> PaO\u2082\/FiO\u2082 ratio improved with NAVA (238 vs 207 mmHg).<\/li>\n<li><strong>Ventilatory pattern:<\/strong> Tidal volumes were slightly lower with NAVA (6.7 vs 7.2 mL\/kg PBW), but <strong>variability in airway pressure and ventilation was greater<\/strong>, reflecting more physiologic breathing.<\/li>\n<li><strong>Obesity effect:<\/strong> Outcomes with NAVA were <strong>similar in obese and non-obese patients<\/strong>; obesity did not impair safety or efficacy.<\/li>\n<li><strong>Safety:<\/strong> No adverse events were observed in either group.<\/li>\n<\/ol>\n<hr class=\"reader-divider-block__horizontal-rule\" \/>\n<h3 id=\"ember67\" class=\"ember-view reader-text-block__heading-3\">Why This Matters<\/h3>\n<p id=\"ember68\" class=\"ember-view reader-text-block__paragraph\">Obesity complicates mechanical ventilation due to impaired lung mechanics and higher risk of dyssynchrony. This study shows <strong>NAVA is both feasible and advantageous in obese patients<\/strong>, enhancing synchrony and oxygenation while maintaining physiologic variability.<\/p>\n<hr class=\"reader-divider-block__horizontal-rule\" \/>\n<h3 id=\"ember69\" class=\"ember-view reader-text-block__heading-3\">Conclusion<\/h3>\n<p id=\"ember70\" class=\"ember-view reader-text-block__paragraph\">NAVA is <strong>safe, feasible, and beneficial<\/strong> for critically ill obese patients compared with PSV. Larger studies are needed to determine if these physiological gains translate into <strong>shorter weaning times, fewer complications, and improved survival<\/strong>.<\/p>\n<hr class=\"reader-divider-block__horizontal-rule\" \/>\n<h3 id=\"ember71\" class=\"ember-view reader-text-block__heading-3\">Take-Home for Clinicians<\/h3>\n<ul>\n<li><strong>Consider NAVA<\/strong> in obese ICU patients when PSV yields dyssynchrony.<\/li>\n<li>Expect <strong>better oxygenation, reduced ineffective efforts, and improved trigger performance<\/strong>.<\/li>\n<li>Recognize that technical double triggering may occur, but without harm.<\/li>\n<\/ul>\n<hr class=\"reader-divider-block__horizontal-rule\" \/>\n<p id=\"ember73\" class=\"ember-view reader-text-block__paragraph\"><strong>Discussion Question:<\/strong> Should <strong>NAVA replace PSV<\/strong> as the preferred mode for obese ICU patients during weaning, given its synchrony and oxygenation benefits?<\/p>\n<p><strong><a class=\"article-editor-link article-editor-link\" style=\"font-size: 16px; background-color: #ffffff;\" href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2110582025001426?via%3Dihub\" rel=\"noopener noreferrer\">ACCESS FULL ARTICLE HERE<\/a><\/strong><\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"alignnone size-medium wp-image-1395\" src=\"https:\/\/perfusfind.com\/ic\/wp-content\/uploads\/2026\/03\/1756515274729-300x300.png\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https:\/\/perfusfind.com\/ic\/wp-content\/uploads\/2026\/03\/1756515274729-300x300.png 300w, https:\/\/perfusfind.com\/ic\/wp-content\/uploads\/2026\/03\/1756515274729-150x150.png 150w, https:\/\/perfusfind.com\/ic\/wp-content\/uploads\/2026\/03\/1756515274729.png 490w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<h3 id=\"ember76\" class=\"ember-view reader-text-block__heading-3\">Take Advantage of This Resource<\/h3>\n<p id=\"ember77\" class=\"ember-view reader-text-block__paragraph\">I encourage you to explore this growing <strong>library of articles<\/strong> and leverage it to stay informed on the latest in critical care. Visit the collection today at: <a class=\"aAIDarVlJjjXEMUykBwFgJhXtzETCscLwRim \" tabindex=\"0\" href=\"https:\/\/perfusfind.com\/ic\/\" target=\"_self\" data-test-app-aware-link=\"\"><strong>https:\/\/perfusfind.com\/ic\/<\/strong><\/a><\/p>\n<p id=\"ember78\" class=\"ember-view reader-text-block__paragraph\">This is another step in making high-quality, evidence-based information easily accessible to the critical care community. As always, thank you for your continued support!<\/p>\n<p id=\"ember79\" class=\"ember-view reader-text-block__paragraph\"><em>As always, don\u2019t forget to like, share, and subscribe. See you on the other side!<\/em><\/p>\n<hr class=\"reader-divider-block__horizontal-rule\" \/>\n<p id=\"ember80\" class=\"ember-view reader-text-block__paragraph\"><strong>Open Access<\/strong> This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article&#8217;s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article&#8217;s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit <a class=\"aAIDarVlJjjXEMUykBwFgJhXtzETCscLwRim \" tabindex=\"0\" href=\"http:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_self\" data-test-app-aware-link=\"\"><strong>http:\/\/creativecommons.org\/licenses\/by\/4.0\/<\/strong><\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>NAVA vs PSV in Obese ICU Patients: First Evidence of Safety and Benefit Abstract: This randomized crossover study is the first to test Neurally Adjusted Ventilatory Assist (NAVA) in critically ill obese patients. Twenty-one ventilated patients (10 obese, 11 non-obese) underwent 30 minutes of NAVA and PSV each. Researchers assessed safety, patient-ventilator synchrony, oxygenation, and [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1396,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[6],"tags":[477,139,484],"class_list":["post-1386","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-mechanical-ventilation","tag-nava","tag-neurally-adjusted-ventilatory-assist-nava","tag-obesity"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.1.1 - 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