Neurally Adjusted Ventilatory Assist (NAVA) compared to conventional ventilation for patients at risk of difficult or prolonged weaning from invasive mechanical ventilation: The UK NAVA Trial

Approximately half of all patients in ICU need assistance from a ventilator. Although lifesaving, ventilators can harm the lungs weaken breathing muscles, and make chest infections more likely. The sedatives used to reduce discomfort can also cause harm. To reduce these risks, ventilators must be regularly adjusted in response to a patient’s needs.

Technology is now available that adjusts the ventilator automatically in response to patients’ needs. One such technology, called Neurally Adjusted Ventilatory Assist (NAVA), matches each ventilator breath to the patient's own breathing by monitoring their breathing muscle activity. This may reduce harm by automatically matching the breaths delivered by the machine to the patient's needs, as well as shortening the time on ventilation.

This trial aims to determine the effectiveness of NAVA technology for reducing the duration of mechanical ventilation compared to conventional mechanical ventilation.

The trial will include patients from ICUs across the UK with conditions such as lung or heart disease who may need a ventilator for at least two days. Patients will be randomly assigned to receive either usual care or usual care plus NAVA. We will compare ventilation treatment time in each group.

We aim to recruit 900 participants.

Duration of mechanical ventilation (time from randomisation to first successful unassisted breathing or death).

1^st November 2024 to 31^st September 2028