Neurally Adjusted Ventilatory Assist: An Early Clue to Diagnosis of Congenital Central Hypoventilation Syndrome

JOURNAL TITLE: Indian Journal of Critical Care Medicine

Author
1. Abdul Rauf
2. Ramakant Sabharwal
ISSN
0972-5229
DOI
10.5005/jp-journals-10071-23286
Volume
23
Issue
11
Publishing Year
2019
Pages
2
Author Affiliations
    1. Institute of Child Health, Sir Ganga Ram Hospital, New Delhi, India
    2. Sir Ganga Ram Hospital, New Delhi, India
    1. Department of Pediatrics (Neurology), Sir Ganga Ram Hospital, New Delhi, India
  • Article keywords
    Congenital central hypoventilation, Electrical activity of diaphragm, Neurally adjusted ventilatory assist

    Abstract

    Congenital central hypoventilation syndrome (CCHS) is characterized by shallow breathing during sleep due to negligible ventilatory sensitivity to hypercarbia and hypoxemia. It is diagnosed using a genetic test for PHOX2B mutation, which is not easily available. Neurally adjusted ventilatory assist (NAVA) is a spontaneous ventilatory mode that was designed basically for better adapting the ventilator to the patient by using electrical activity of diaphragm (EAdi) signals. We report a case of a 6-month-old infant who presented with recurrent apneas, where differential decrease in EAdi discharges during sleep using NAVA served as an early clue to the diagnosis of CCHS. Definitive diagnosis was later confirmed by genetic testing.

    © 2019 Jaypee Brothers Medical Publishers (P) LTD.   |   All Rights Reserved