Evidence map›Paper›PMID 33293357›Full record

ArticleBMJ open respiratory research2020

Factors affecting the use of neurally adjusted ventilatory assist in the adult critical care unit: a clinician survey.

Daniel Hadfield, Louise Rose, Fiona Reid, Victoria Cornelius, Nicholas Hart, Clare Finney, Bethany Penhaligon, Clare Harris, Sian Saha, Harriet Noble and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open respiratory research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. From theory to practice: implementing an education bundle for neurally adjusted ventilatory assist (NAVA) in the intensive care unit.Journal of perinatology : official journal of the California Perinatal Association · 2026
    Article
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Daniel HadfieldCritical Care Research, King's College Hospital, London, UK daniel.hadfield@nhs.net.
Louise RoseKing's College London Florence Nightingale School of Nursing and Midwifery, London, London, UK.
Fiona ReidKing's College London School of Population Health and Environmental Sciences, London, London, UK.
Victoria CorneliusImperial College London School of Public Health, London, London, UK.
Nicholas HartCentre for Human and Applied Physiological Sciences, King's College London School of Biomedical Sciences, London, UK.
Clare FinneyCritical Care Research, King's College Hospital, London, UK.
Bethany PenhaligonCritical Care Research, King's College Hospital, London, UK.
Clare HarrisCritical Care Research, King's College Hospital, London, UK.
Sian SahaCritical Care Research, King's College Hospital, London, UK.
Harriet NobleCritical Care Research, King's College Hospital, London, UK.
John SmithCritical Care Research, King's College Hospital, London, UK.
Philip Anthony Hopkins *Critical Care Research, King's College Hospital, London, UK.
Gerrard Francis Rafferty *King's College London, Centre for Human and Applied Physiological Sciences, London, UK.

Funding

Department of Health CDRF-2014-05-056
6 · The paper itself

Abstract

backgroundNeurally adjusted ventilatory assist (NAVA) involves an intricate interaction between patient, clinician and technology. To improve our understanding of this complex intervention and to inform future trials, this survey aimed to examine clinician attitudes, beliefs and barriers to NAVA use in critically ill adults within an institution with significant NAVA experience.

methodsA survey of nurses, doctors and physiotherapists in four Intensive Care Units (ICUs) of one UK university-affiliated hospital (75 NAVA equipped beds). The survey consisted of 39 mixed open and structured questions. The hospital had 8 years of NAVA experience prior to the survey.

resultsOf 466 distributed questionnaires, 301 (64.6%) were returned from 236 nurses (78.4%), 53 doctors (17.6%) and 12 physiotherapists (4.0%). Overall, 207/294 (70.4%) reported clinical experience. Most agreed that NAVA was safe (136/177, 76.8%) and clinically effective (99/176, 56.3%) and most perceived 'improved synchrony', 'improved comfort' and 'monitoring the diaphragm' to be key advantages of NAVA. 'Technical issues' (129/189, 68.3%) and 'NAVA signal problems' (94/180, 52.2%) were the most cited clinical disadvantage and cause of mode cross-over to Pressure Support Ventilation (PSV), respectively. Most perceived NAVA to be more difficult to use than PSV (105/174, 60.3%), although results were mixed when compared across different tasks. More participants preferred PSV to NAVA for initiating ventilator weaning (93/171 (54.4%) vs 29/171 (17.0%)). A key barrier to use and a consistent theme throughout was 'low confidence' in relation to NAVA use.

conclusionsIn addition to broad clinician support for NAVA, this survey describes technical concerns, low confidence and a perception of difficulty above that associated with PSV. In this context, high-quality training and usage algorithms are critically important to the design and of future trials, to clinician acceptance and to the clinical implementation and future success of NAVA.

Indexed as

Interactive Ventilatory SupportAdultCritical CareHumansPositive-Pressure RespirationSurveys and QuestionnairesVentilator Weaningassisted ventilation

Identifiers

PMID33293357
PMCPMC7725091

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.