A1 Refereed original research article in a scientific journal
Non-invasive neurally adjusted ventilatory assist versus nasal intermittent positive-pressure ventilation in preterm infants born before 30 weeks' gestation
Authors: Kousuke Yonehara, Ryo Ogawa, Yoshiya Kamei, Arata Oda, Masayo Kokubo, Takehiko Hiroma, Tomohiko Nakamura
Publisher: WILEY
Publication year: 2018
Journal: Pediatrics International
Journal name in source: PEDIATRICS INTERNATIONAL
Journal acronym: PEDIATR INT
Volume: 60
Issue: 10
First page : 957
Last page: 961
Number of pages: 5
ISSN: 1328-8067
eISSN: 1442-200X
DOI: https://doi.org/10.1111/ped.13680
Abstract
BackgroundNon-invasive neurally adjusted ventilatory assist (NIV-NAVA), a mode of non-invasive ventilation (NIV) controlled by diaphragmatic electrical activity, may be superior to other NIV as a respiratory support after extubation in preterm infants, but no report has compared NIV-NAVA with other NIV methods. We evaluated the effectiveness and adverse effects of NIV-NAVA after extubation in preterm infants <30weeks of gestation.MethodsResultsThis retrospective study involved patients who were born before 30weeks of gestation. We mainly used NIV-NAVA or nasal intermittent positive-pressure ventilation (NIPPV) for preterm infants as the NIV after extubation and compared these two groups. The primary outcome was treatment failure. The secondary outcomes were extubation failure and adverse events. Treatment failure was defined as a change of NIV (NIPPV was switched to NIV-NAVA, or NIV-NAVA was switched to NIPPV) or reintubation 7days after extubation.Fifteen patients were in the NIV-NAVA group, and 19 were in the NIPPV group. The gestational age of the NIV-NAVA group was younger than that of the NIPPV group (25.7 2.4weeks vs 27.3 +/- 1.8weeks). Treatment failure occurred in six cases (40%) in the NIV-NAVA group and in nine cases (47.4%) in the NIPPV group, and no significant difference was demonstrated. No significant difference in adverse events was noted.ConclusionsNIV-NAVA has advantages compared with NIPPV as the NIV for premature infants after extubation. NIV-NAVA can also be used safely without a significant difference in the rate of complications compared with NIPPV.
BackgroundNon-invasive neurally adjusted ventilatory assist (NIV-NAVA), a mode of non-invasive ventilation (NIV) controlled by diaphragmatic electrical activity, may be superior to other NIV as a respiratory support after extubation in preterm infants, but no report has compared NIV-NAVA with other NIV methods. We evaluated the effectiveness and adverse effects of NIV-NAVA after extubation in preterm infants <30weeks of gestation.MethodsResultsThis retrospective study involved patients who were born before 30weeks of gestation. We mainly used NIV-NAVA or nasal intermittent positive-pressure ventilation (NIPPV) for preterm infants as the NIV after extubation and compared these two groups. The primary outcome was treatment failure. The secondary outcomes were extubation failure and adverse events. Treatment failure was defined as a change of NIV (NIPPV was switched to NIV-NAVA, or NIV-NAVA was switched to NIPPV) or reintubation 7days after extubation.Fifteen patients were in the NIV-NAVA group, and 19 were in the NIPPV group. The gestational age of the NIV-NAVA group was younger than that of the NIPPV group (25.7 2.4weeks vs 27.3 +/- 1.8weeks). Treatment failure occurred in six cases (40%) in the NIV-NAVA group and in nine cases (47.4%) in the NIPPV group, and no significant difference was demonstrated. No significant difference in adverse events was noted.ConclusionsNIV-NAVA has advantages compared with NIPPV as the NIV for premature infants after extubation. NIV-NAVA can also be used safely without a significant difference in the rate of complications compared with NIPPV.
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