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Am J Perinatol 2017; 34(06): 593-598
DOI: 10.1055/s-0036-1596053
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Noninvasive Neurally Adjusted Ventilatory Assist in Premature Infants Postextubation

Tarah T. Colaizy
1   Division of Neonatology, Department of Pediatrics, Carver College of Medicine, Iowa City, Iowa
,
Gary J. Kummet
2   Mercy Medical Center, Des Moines, Iowa
,
Colleen M. Kummet
3   Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
,
Jonathan M. Klein
1   Division of Neonatology, Department of Pediatrics, Carver College of Medicine, Iowa City, Iowa
› Author Affiliations
Further Information

Publication History

20 August 2016

21 October 2016

Publication Date:
05 December 2016 (online)

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Abstract

Background Neurally adjusted ventilatory assist (NAVA) has distinct advantages when used invasively compared with conventional ventilation techniques. Evidence supporting the use of noninvasive NAVA is less robust, especially in the very low birth weight (VLBW) population.

Objective To determine whether synchronized noninvasive ventilation via neurally adjusted ventilatory assist (NIV NAVA) supports ventilation postextubation in premature infants.

Methods A retrospective analysis of a cohort of twenty-four former VLBW (<1.5 kg) infants from July 2011 to October 2012. Decreased or unchanged capillary pCO2 after increasing NAVA support was used as a marker for adequately supported noninvasive ventilation. The Wilcoxon signed-rank test was used to compare pre- and post-NAVA intervention (α = 0.05).

Results Ventilation improved after an increase in NIV NAVA level in 83% of the premature infants studied (20/24) with a decrease in median pCO2 by 5 mm Hg (p = 0.0001).

Conclusion NIV NAVA can provide synchronized postextubation ventilatory support as measured by decreased pCO2 in premature infants.

Keywords

neurally adjusted ventilatory assist - noninvasive ventilation - very low birth weight

Note

First draft was written by Tarah Colaizy, MD, MPH. This study was presented in an abstract format at the Pediatric Academic Societies Meeting in May 2013.


 

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