Recently,modes of mechanical ventilation that synchronize not only the timing,but also the level of assistance tO the patient's own effort,have been introduced.Neurally adjusted ventilatory assist (NAVA)is one of these mechanical ventilation modes in which the ventilator is controlled by the electrical activity of the diaphragm.It has been designed with the goal of improving patient-ventilator interaction by matching the ventilator support with the neural output of the respiratory centers.NAVA can safely and efficiently unload the respiratory muscles during maximal inspiratory maneuvers-without failing tO cycle-off ventilatory assist and without causing excessive lung distention.NAVA should not be affected by leaks and can unload the respiratory muscles while maintaining synchrony with the subject's demand.NAVA opens up a new era in mechanical ventilation.