Clinical review: Update on neurally adjusted ventilatory assist - report of a round-table conference.

ABSTRACT: Conventional mechanical ventilators rely on pneumatic pressure and flow sensors and controllers to detect breaths. New modes of mechanical ventilation have been developed to better match the assistance delivered by the ventilator to the patient's needs. Among these modes, neurally adjusted ventilatory assist (NAVA) delivers a pressure that is directly proportional to the integral of the electrical activity of the diaphragm recorded continuously through an esophageal probe. In clinical settings, NAVA has been chiefly compared with pressure-support ventilation, one of the most popular modes used during the weaning phase, which delivers a constant pressure from breath to breath. Comparisons with proportional-assist ventilation, which has numerous similarities, are lacking. Because of the constant level of assistance, pressure-support ventilation reduces the natural variability of the breathing pattern and can be associated with asynchrony and/or overinflation. The ability of NAVA to circumvent these limitations has been addressed in clinical studies and is discussed in this report. Although the underlying concept is fascinating, several important questions regarding the clinical applications of NAVA remain unanswered. Among these questions, determining the optimal NAVA settings according to the patient's ventilatory needs and/or acceptable level of work of breathing is a key issue. In this report, based on an investigator-initiated round table, we review the most recent literature on this topic and discuss the theoretical advantages and disadvantages of NAVA compared with other modes, as well as the risks and limitations of NAVA.

European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the Second International Consensus Conference on Home Blood Pressure Monitoring

This document summarizes the available evidence and provides recommendations on the use of home blood pressure monitoring in clinical practice and in research. It updates the previous recommendations on the same topic issued in year 2000. The main topics addressed include the methodology of home blood pressure monitoring, its diagnostic and therapeutic thresholds, its clinical applications in hypertension, with specific reference to special populations, and its applications in research. The final section deals with the problems related to the implementation of these recommendations in clinical practice.

Informe de la Reunión Regional Latinoamericana Preparatoria de la Conferencia Internacional sobre Población, realizada en el marco del Séptimo Período de Sesiones del Comité de Expertos Gubernamentales de Alto Nivel = Report of the Latin American Regional Preparatory Meeting for the International Conference on Population, held within the Seventh Session of the Committee of High-Level Government Experts

Incluye Bibliografía

Report of the Fourth Meeting of the Statistical Conference of the Americas of the Economic Commission for Latin America and the Caribbean

Includes bibliography

Report of the Seventh Meeting of the Executive Committee of the Statistical Conference of the Americas of the Economic Commission for Latin America and the Caribbean

Includes bibliography

Report of activities and draft programme of work of the working group on gender statistics of the Statistical Conference of the Americas of the Economic Commission for Latin America and the Caribbean

Includes bibliography

Report of the Eighth Meeting of the Executive Committee of the Statistical Conference of the Americas of the Economic Commission for Latin America and the Caribbean

Includes bibliography