Neurally Adjusted Ventilatory Assist in Very Prematurely Born Infants with Evolving/Established Bronchopulmonary Dysplasia

Background During neurally adjusted ventilatory assist (NAVA)/noninvasive (NIV) NAVA, a modified nasogastric feeding tube with electrodes monitors the electrical activity of the diaphragm (Edi). The Edi waveform determines the delivered pressure from the ventilator. Objective Our objectiv...

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Autores principales:	Sandeep Shetty, Katie Evans, Peter Cornuaud, Anay Kulkarni, Donovan Duffy, Anne Greenough
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical Publishers, Inc. 2021
Materias:	neurally adjusted ventilatory assist prematurity neonatal trigger ventilation length of hospital stay ventilation days Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/81c3a2d4cba24293a7872e9d7699aceb
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spelling	oai:doaj.org-article:81c3a2d4cba24293a7872e9d7699aceb2021-11-24T00:11:00ZNeurally Adjusted Ventilatory Assist in Very Prematurely Born Infants with Evolving/Established Bronchopulmonary Dysplasia2157-69982157-700510.1055/s-0041-1739458https://doaj.org/article/81c3a2d4cba24293a7872e9d7699aceb2021-10-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1739458https://doaj.org/toc/2157-6998https://doaj.org/toc/2157-7005Background During neurally adjusted ventilatory assist (NAVA)/noninvasive (NIV) NAVA, a modified nasogastric feeding tube with electrodes monitors the electrical activity of the diaphragm (Edi). The Edi waveform determines the delivered pressure from the ventilator. Objective Our objective was to determine whether NAVA/NIV-NAVA has advantages in infants with evolving/established bronchopulmonary dysplasia (BPD). Methods Each infant who received NAVA/NIV-NAVA and conventional invasive and NIV was matched with two historical controls. Eighteen NAVA/NIV-NAVA infants’ median gestational age, 25.3 (23.6–28.1) weeks, was compared with 36 historical controls’ median gestational age 25.2 (23.1–29.1) weeks. Results Infants on NAVA/NIV-NAVA had lower extubation failure rates (median: 0 [0–2] vs. 1 [0–6] p = 0.002), shorter durations of invasive ventilation (median: 30.5, [1–90] vs. 40.5 [11–199] days, p = 0.046), and total duration of invasive and NIV to the point of discharge to the local hospital (median: 80 [57–140] vs. 103.5 [60–246] days, p = 0.026). The overall length of stay (LOS) was lower in NAVA/NIVNAVA group (111.5 [78–183] vs. 140 [82–266] days, p = 0.019). There were no significant differences in BPD (17/18 [94%] vs. 32/36 [89%] p = 0.511) or home oxygen rates (14/18 [78%] vs. 23/36 [64%] p = 0.305). Conclusion The combination of NAVA/NIV-NAVA compared with conventional invasive and NIV modes may be advantageous for preterm infants with evolving/established BPD.Sandeep ShettyKatie EvansPeter CornuaudAnay KulkarniDonovan DuffyAnne GreenoughThieme Medical Publishers, Inc.articleneurally adjusted ventilatory assistprematurityneonatal trigger ventilationlength of hospital stayventilation daysGynecology and obstetricsRG1-991ENAmerican Journal of Perinatology Reports, Vol 11, Iss 04, Pp e127-e131 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	neurally adjusted ventilatory assist prematurity neonatal trigger ventilation length of hospital stay ventilation days Gynecology and obstetrics RG1-991
spellingShingle	neurally adjusted ventilatory assist prematurity neonatal trigger ventilation length of hospital stay ventilation days Gynecology and obstetrics RG1-991 Sandeep Shetty Katie Evans Peter Cornuaud Anay Kulkarni Donovan Duffy Anne Greenough Neurally Adjusted Ventilatory Assist in Very Prematurely Born Infants with Evolving/Established Bronchopulmonary Dysplasia
description	Background During neurally adjusted ventilatory assist (NAVA)/noninvasive (NIV) NAVA, a modified nasogastric feeding tube with electrodes monitors the electrical activity of the diaphragm (Edi). The Edi waveform determines the delivered pressure from the ventilator. Objective Our objective was to determine whether NAVA/NIV-NAVA has advantages in infants with evolving/established bronchopulmonary dysplasia (BPD). Methods Each infant who received NAVA/NIV-NAVA and conventional invasive and NIV was matched with two historical controls. Eighteen NAVA/NIV-NAVA infants’ median gestational age, 25.3 (23.6–28.1) weeks, was compared with 36 historical controls’ median gestational age 25.2 (23.1–29.1) weeks. Results Infants on NAVA/NIV-NAVA had lower extubation failure rates (median: 0 [0–2] vs. 1 [0–6] p = 0.002), shorter durations of invasive ventilation (median: 30.5, [1–90] vs. 40.5 [11–199] days, p = 0.046), and total duration of invasive and NIV to the point of discharge to the local hospital (median: 80 [57–140] vs. 103.5 [60–246] days, p = 0.026). The overall length of stay (LOS) was lower in NAVA/NIVNAVA group (111.5 [78–183] vs. 140 [82–266] days, p = 0.019). There were no significant differences in BPD (17/18 [94%] vs. 32/36 [89%] p = 0.511) or home oxygen rates (14/18 [78%] vs. 23/36 [64%] p = 0.305). Conclusion The combination of NAVA/NIV-NAVA compared with conventional invasive and NIV modes may be advantageous for preterm infants with evolving/established BPD.
format	article
author	Sandeep Shetty Katie Evans Peter Cornuaud Anay Kulkarni Donovan Duffy Anne Greenough
author_facet	Sandeep Shetty Katie Evans Peter Cornuaud Anay Kulkarni Donovan Duffy Anne Greenough
author_sort	Sandeep Shetty
title	Neurally Adjusted Ventilatory Assist in Very Prematurely Born Infants with Evolving/Established Bronchopulmonary Dysplasia
title_short	Neurally Adjusted Ventilatory Assist in Very Prematurely Born Infants with Evolving/Established Bronchopulmonary Dysplasia
title_full	Neurally Adjusted Ventilatory Assist in Very Prematurely Born Infants with Evolving/Established Bronchopulmonary Dysplasia
title_fullStr	Neurally Adjusted Ventilatory Assist in Very Prematurely Born Infants with Evolving/Established Bronchopulmonary Dysplasia
title_full_unstemmed	Neurally Adjusted Ventilatory Assist in Very Prematurely Born Infants with Evolving/Established Bronchopulmonary Dysplasia
title_sort	neurally adjusted ventilatory assist in very prematurely born infants with evolving/established bronchopulmonary dysplasia
publisher	Thieme Medical Publishers, Inc.
publishDate	2021
url	https://doaj.org/article/81c3a2d4cba24293a7872e9d7699aceb
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Neurally Adjusted Ventilatory Assist in Very Prematurely Born Infants with Evolving/Established Bronchopulmonary Dysplasia

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