Servo-n Neonatal Ventilator
They deserve our best from the very beginning
Newborns should not have to start their lives battling for it. But some will, and the best we can do is help create an ideal environment for them to breathe, sleep and grow - while minimizing as many risks as possible to their physical and mental development.
Ready for the reality of NICU
Servo-n Neonatal Ventilator was created to help provide vulnerable neonates with the support they need while protecting the lungs, brain, and other developing organs. Sensitive and responsive, Servo-n compensates for variable leakage in both invasive* and non-invasive modes of ventilation. Servo-n can deliver tidal volumes as low as 2ml in patients as small as 0.3kg and includes optional hot-wire flow sensor technology to both trigger and measure pressure and flow at the patient interface.
* Leak compensation in invasive modes is only available in the neonatal patient category and is not available in Bi-Vent.
Servo-n also enables you to monitor the electrical activity of the diaphragm (Edi). This signal reflects the neonate’s neural respiratory drive, breath by breath. With it, you can determine the optimal level of assist at any given time, in any mode of ventilation. Servo-n includes Neurally Adjusted Ventilatory Assist (NAVA®), a ventilation mode with the ability to match support to the irregular breathing patterns of neonates. There are many benefits with using NAVA, such as reduced work of breathing1, lower peak pressures and FiO2 requirements2, and improved comfort3. All of these benefits help you support neonates breathing spontaneously, while potentially reducing the need for sedation and time on ventilation.4
Servo-n makes for simple and intuitive setup, monitoring, and operation. You’re never more than a touch away from on-screen support.
Babies who start their lives in the NICU will have some catching up to do. Help them breathe, sleep and grow with Servo-n.
NEW Built-in High Flow therapy
High Flow therapy reduces the patient’s work of breathing by delivering a gas flow volume to meet or exceed the patient’s inspiratory flow rate, supporting the patient’s own efforts and minimizing limitations.This therapy involves a set flow that drives the accurate level of heated and humidified oxygen, improving patient comfort and tolerance. The integrated nebulization can be used during High Flow therapy.
NEW Servo Compass
Servo Compass on Servo-u and Servo-n target-guided ventilation
The ventilator is an indispensable tool in the ICU area. Used wisely it may help reduce the risks of Ventilator Induced Lung Injury (VILI).
Servo Compass visualizes the volume and pressure of each breath in relation to set targets.
Servo Compass® allows clinicians to visually assess patients at a glance for low tidal volumes and peak pressures, alerting clinicians to changing conditions and allowing them to intervene with appropriate therapy. Servo Compass® joins NAVA® and Edi monitoring as part of the Servo portfolio focusing on lung protection and activation of the diaphragm. The goal of which is to enable clinicians to promote lung protective ventilation and wean patients from the ventilator.
How to detect deviations from ventilation targets with Servo Compass
Patient on target
Volume and pressure OK
Increased risk for volutrauma
Too high volume
Increased risk for atelectotrauma
Too low volume
Increased risk for barotrauma
Too high pressure
the Servo-u Ventilator
The intuitive ICU ventilator that inspires confidence and provides multiple options for protective ventilation. A solid foundation for the future.
Ventilation where the patient’s own respiratory drive controls timing and assist delivered by the ventilator.
the Servo-i Ventilator
A wealth of features and functionalities for treating adult, pediatric and neonatal patients.
Based on proven Servo technology, ensuring safe, reliable and high quality ventilation.
1. Bhandari V. Synchronized ventilation in neonates: a brief reveiw. Neonatology
2. Vignaux L, Grazioli S, Piquilloud L, Bochaton N, Karam O, Jaecklin T, Levy-jamet
Y, Tourneux P, Jolliet P, Rimensberger P. Optimizing patient ventilator synchrony
during invasive ventilator assist in children and infants remains a difficult task.
PCCM In Press, June 2013.
3. Emeriaud G, Larouche A, Ducharme-Crevier L, Massicotte E, Fléchelles O,
Pellerin-Leblanc AA, Morneau S, Beck J, Jouvet P. Evolution of inspiratory
diaphragm activity in children over the course of the PICU stay. Intensive Care
Med. 2014 Nov;40(11):1718-26.
4. Brander L, Leong-Poi H, Beck J, Brunet F, Hutchison SJ, Slutsky AS, et al. Titration
and implementation of neurally adjusted ventilatory assist in critically ill
patients. Chest 2009;135:695e703.
5. Bordessoule A, Emeriaud G, Morneau S, Jouvet P, Beck J. Neurally Adjusted
Ventilatory Assist (NAVA) improves patient-ventilator interaction in infants
compared to conventional ventilation. Pediatr Res. 2012 May 11. doi: 10.1038/
6. Chen Z, Luo F, Ma XL, Lin HJ, Shi LP, DU LZ. Application of neurally adjusted
ventilatory assist in preterm infants with respiratory distress syndrome].
Zhongguo Dang Dai Er Ke Za Zhi. 2013 Sep;15(9): 709-12.
7. Clement KC, Thurman TL, Holt SJ, et al. Neurally triggered breaths reduce
trigger delay and improve ventilator response times in ventilated infants with
bronchiolitis. Intensive Care Med 2011;37:1826–32.
8. Firestone KS, Beck J, Stein H. Neurally Adjusted Ventilatory Assist for
Noninvasive Support in Neonates. Clin Perinatol. 2016 Dec;43(4):707-724.
9. Stein H, Beck J, Dunn M. Non-invasive ventilation with neurally adjusted
ventilatory assist in newborns. Semin Fetal Neonatal Med 2016;21(3):154–61.
10. Kallio M, Peltoniemi O, Anttila E, Pokka T, Kontiokari T. Neurally Adjusted
Ventilatory Assist (NAVA) in Pediatric Intensive Care – A Randomized Controlled
Trial. Pediatr Pulmonol. 2015 Jan;50(1):55-62.
11. de la Oliva P, Schuffelmann C, Gomez-Zamora A, Vilar J, Kacmarek RM.
Asynchrony, neural drive, ventilatory variability and COMFORT: NAVA vs
pressure support in pediatric patients. A randomized cross-over trial. Int Care
med. Epub ahead of print April 6 2012.
12. Lee J, Kim HS, Sohn JA, Lee JA, Choi CW, Kim EK, Kim BI, Choi JH. Randomized
Crossover Study of Neurally Adjusted Ventilatory Assist in Preterm Infants. J
Pediatr. 2012 Jun 1.
13. Zhu LM, Shi ZY, Ji G, Xu ZM, Zheng JH, Zhang HB, Xu ZW, Liu JF. [Application of
neurally adjusted ventilatory assist in infants who underwent cardiac surgery for
congenital heart disease]. Zhongguo Dang Dai Er Ke Za Zhi. 2009 Jun;11(6):433-6.
14. Stein H, Howard D. Neurally Adjusted Ventilatory Assist (NAVA) in Neonates less
than 1500 grams: a retrospective analysis. J Pediatr 2012;160:786e9.
15. Piastra M, De Luca D, Costa R, Pizza A, De Sanctis R, Marzano L, Biasucci D,
Visconti F, Conti G. Neurally adjusted ventilatory assist vs pressure support
ventilation in infants recovering from severe acute respiratory distress
syndrome: Nested study. J Crit Care. 2013 Oct 24.
16. Gibu C, Cheng P, Ward RJ, Castro B, Heldt GP. Feasibility and physiological
effects of non-invasive neurally-adjusted ventilatory assist (NIV-NAVA) in
preterm infants. Pediatr Res. 2017 Apr 11.
17. Amigoni A, Rizzi G, Divisic A, Brugnaro L, Conti G, Pettenazzo A. Effects of
propofol on diaphragmatic electrical activity in mechanically ventilated
pediatric patients. Intensive Care Med. 2015 Oct;41(10):1860-1.
18. Parikka V, Beck J, Zhai Q, Leppäsalo J, Lehtonen L, Soukka H. The effect of
caffeine citrate on neural breathing pattern in preterm infants. Early Hum Dev.
19. Stein H, Firestone K. Application of neurally adjusted ventilatory assist in
neonates. Semin Fetal Neonatal. Semin Fetal Neonatal Med. 2014 Feb;19(1):60-9.
20. Stein H. NAVA ventilation allows for patient determination of peak pressures
facilitating weaning in response to improving lung compliance during
Respiratory Distress Syndrome: a case report. Neonatol Today 2010;5:1e4.
21. Colombo D, Cammarota G, Alemani M, et al. Efficacy of ventilator waveforms
observation in detecting patient-ventilator asynchrony. Crit Care Med. 2011
22. Rahmani A, Ur Rehman N, Chedid F. Neurally adjusted ventilatory assist (NAVA)
mode as an adjunct diagnostic tool in congenital central hypoventilation
syndrome. J Coll Physicians Surg Pak 2013; Feb:23(2):154-156.
23. Ducharme-Crevier L, Du Pont-Thibodeau G, Emeriaud G. Interest of Monitoring
Diaphragmatic Electrical Activity in the Pediatric Intensive Care Unit. Crit Care
Res Pract. 2013; 2013: 384210.
24. Soukka H, Grönroos L, Leppäsalo J, Lehtonen L. The effects of skin-to-skin care
on the diaphragmatic electrical activity in preterm infants. Early Hum Dev. 2014
25. Wolf G, Walsh B, Green M, Arnold J. Electrical activity of the diaphragm during
extubation readiness testing in critically ill children. Pediatr Crit Care Med
26. Poets CF, Roberts RS, Schmidt B, Whyte RK, Asztalos EV, Bader D, Bairam A,
Moddemann D, Peliowski A, Rabi Y, Solimano A, Nelson H; Canadian Oxygen Trial
Investigators. Association Between Intermittent Hypoxemia or Bradycardia
and Late Death or Disability in Extremely Preterm Infants. JAMA. 2015 Aug
27. Morley CJ, Davis PG, Doyle LW, Brion LP, Hascoet JM, Carlin JB; COIN Trial
Investigators. Nasal CPAP or intubation at birth for very preterm infants. N Engl J
Med. 2008 Feb 14;358(7):700-8.
28. SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research
Network, Finer NN, et al. Early CPAP versus surfactant in extremely preterm
infants. N Engl J Med. 2010 May 27;362(21):1970-9.
29. Courtney SE, Pyon KH, Saslow JG, Arnold GK, Pandit PB, Habib RH. Lung
recruitment and breathing pattern during variable versus continuous flow nasal
continuous positive airway pressure in premature infants: an evaluation of three
devices. Pediatrics. 2001 Feb;107(2):304-8.
30. Beck J, Reilly M, Grasselli G, et al. Patient-ventilator interaction during
neutrally adjusted ventilatory assist in low birth weight infants. Pediatr Res
31. Houtekie L, Moerman D, Bourleau A, Reychler G, Detaille T, Derycke E,
Clément de Cléty S. Feasibility Study on Neurally Adjusted Ventilatory Assist
in Noninvasive Ventilation After Cardiac Surgery in Infants. Respir Care. 2015
32. Lee J, Kim HS, Jung YH, Shin SH, Choi CW, Kim EK, Kim BI, Choi JH. Non-invasive
neurally adjusted ventilatory assist in preterm infants: a randomised phase II
crossover trial. Arch Dis Child Fetal Neonatal Ed. 2015 Nov;100(6):F507-13.
33. Zhu LM, Xu ZM, Ji G, Cai XM, Liu XR, Zheng JH, Zhang HB, Shi ZY, Xu ZW, Liu JF.
[Effect of prone or spine position on mechanically ventilated neonates after
cardiac surgery with acute lung injury]. Zhonghua Yi Xue Za Zhi. 2010 May
34. Lehtonen, L. (EPNV, 2014). NAVA experiences and research in preterm infants.
Retrieved from http://www.criticalcarenews.com.
35. Lehtonen, L. (EPNV, 2014). Hospital in Finland experiences a weight gain of 35%
with NAVA - neonatal NAVA and individualizing treatment at bedside. . Retrieved
36. Terzi N, Pelieu I, Guittet L, Ramakers M, Seguin A, Daubin C, Charbonneau P, du
Cheyron D, Lofaso F. Neurally adjusted ventilatory assist in patients recovering
spontaneous breathing after acute respiratory distress syndrome: physiological
evaluation. Crit Care Med. 2010 Sep;38(9):1830-7.
37. Kallio M, Koskela U, Peltoniemi O,Kontiokari T, Pokka T, Suo-Palosaari M, Saarela
T. Neurally adjusted ventilatory assist (NAVA) in preterm newborn infants with
respiratory distress syndrome-a randomized controlled trial. Eur J Pediatr. 2016
38. Delisle S, Ouellet P, Bellemare P, Tetrault J, Arsenault P. Sleep quality in
mechanically ventilated patients: comparison between NAVA and PSV modes.
Ann Intensive Care 2011:1. On-line.
39. Longhini F, Ferrero F, De Luca D, Cosi G, Alemani M, Colombo D, Cammarota G,
Berni P, Conti G, Bona G, Della Corte F, Navalesi P. Neurally adjusted ventilatory
assist in preterm neonates with acute respiratory failure. Neonatology.
40. Morita P, et al. The usability of ventilators: a comparative evaluation of use safety
and user experience. Crit Care. 2016; 20: 263.
41. Poddutoor PK, Chirla DK, Sachane K, Shaik FA, Venkatlakshmi A. Rescue high
frequency oscillation in neonates with acute respiratory failure. Indian Pediatr.
42. Iscan B, Duman N, Tuzun F, Kumral A, Ozkan H. Impact of Volume Guarantee
on High-Frequency Oscillatory Ventilation in Preterm Infants: A Randomized
Crossover Clinical Trial. Neonatology. 2015;108(4):277-82.
43. Stein H. (APA, 2014). Neonatal outcomes. Retrieved from
44. Dysart K et al. Research in high flow therapy: mechanisms of action. Respir Med. 2009 Oct;103(10):1400-5.
45. Gotera C et al. Clinical evidence on high flow oxygen therapy and active humidification in adults. Rev Port Pneumol. 2013; 19(5):217–227.