Medicina intensiva
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Neurally adjusted ventilatory assist (NAVA) is a new mode of assisted mechanical ventilation that uses the signal obtained from diaphragmatic electrical activity (Edi) to control the mechanical ventilator. Edi directly represents the central respiratory drive and reflects the length and intensity of the patient's neural effort. ⋯ During inspiration, the pressure delivered is proportional to the Edi and the inspiratory pressure assist ceases when the neural activation of the diaphragm starts to decline after reaching the inspiratory maximum value. NAVA is a new conceptual approach to mechanical ventilation that can significantly improve patient-ventilator interaction and optimize the level of effective respiratory muscle unloading during assisted mechanical ventilation.
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Review Case Reports
[Late amniotic fluid embolism among the diferential diagnosis of acute respiratory failure in the postpartum: case report and review].
The amniotic fluid embolism is an uncommon condition with a high mortality. The cardinal symptoms are hypoxia, hypotension, altered mental status and disseminated intravascular coagulation. ⋯ We describe a case of a primigravida who, after an uneventful delivery, suffers an acute respiratory failure in the late postpartum period. Exclusion of other causes of acute respiratory failure occurring during delivery or in the postpartum period led to establish the diagnosis.