Neurally adjusted ventilatory assist for rapid weaning in preterm infants
Background Neurally adjusted ventilatory assist (NAVA) is a new mode of subject‐triggered ventilation. Experience with the use of NAVA in preterm infants is limited. This study compared the effects of invasive mechanical ventilation with NAVA to conventional intermittent mandatory ventilation (CIMV)...
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| Veröffentlicht in: | Pediatrics international 2023-01, Vol.65 (1), p.e15360-n/a |
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| creator | Fang, Shih‐Jou Su, Chung‐Hao Liao, Da‐Ling Chen, Chih‐Cheng Chung, Mei‐Yung Chen, Feng‐Shun Huang, Hsin‐Chun Ou‐Yang, Mei‐Chen |
| description | Background
Neurally adjusted ventilatory assist (NAVA) is a new mode of subject‐triggered ventilation. Experience with the use of NAVA in preterm infants is limited. This study compared the effects of invasive mechanical ventilation with NAVA to conventional intermittent mandatory ventilation (CIMV) in terms of reducing the duration of oxygen requirement and invasive ventilator support in preterm infants.
Methods
This was a prospective study. We enrolled infants of less than 32 weeks’ gestation who were then randomized to receive either NAVA or CIMV support during hospitalization. We recorded and analyzed data on the maternal history during pregnancy, use of medications, neonatal data at admission, neonatal diseases, and respiratory support in the neonatal intensive care unit.
Results
There were 26 preterm infants in the NAVA group and 27 preterm infants in the CIMV group. Significantly fewer infants in the NAVA group received supplemental oxygen at 28 days of age (12 [46%] vs. 21 [78%], p = 0.0365), and they required significantly fewer days of invasive ventilator support: 7.73 (± 2.39) vs. 17.26 (± 3.65), p = 0.0343.
Conclusions
Compared with CIMV, NAVA appears to allow for more rapid weaning from invasive ventilation and decreases the incidence of bronchopulmonary dysplasia, especially in preterm infants with severe respiratory distress syndrome treated with surfactants. |
| doi_str_mv | 10.1111/ped.15360 |
| format | Article |
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Neurally adjusted ventilatory assist (NAVA) is a new mode of subject‐triggered ventilation. Experience with the use of NAVA in preterm infants is limited. This study compared the effects of invasive mechanical ventilation with NAVA to conventional intermittent mandatory ventilation (CIMV) in terms of reducing the duration of oxygen requirement and invasive ventilator support in preterm infants.
Methods
This was a prospective study. We enrolled infants of less than 32 weeks’ gestation who were then randomized to receive either NAVA or CIMV support during hospitalization. We recorded and analyzed data on the maternal history during pregnancy, use of medications, neonatal data at admission, neonatal diseases, and respiratory support in the neonatal intensive care unit.
Results
There were 26 preterm infants in the NAVA group and 27 preterm infants in the CIMV group. Significantly fewer infants in the NAVA group received supplemental oxygen at 28 days of age (12 [46%] vs. 21 [78%], p = 0.0365), and they required significantly fewer days of invasive ventilator support: 7.73 (± 2.39) vs. 17.26 (± 3.65), p = 0.0343.
Conclusions
Compared with CIMV, NAVA appears to allow for more rapid weaning from invasive ventilation and decreases the incidence of bronchopulmonary dysplasia, especially in preterm infants with severe respiratory distress syndrome treated with surfactants.</description><identifier>ISSN: 1328-8067</identifier><identifier>EISSN: 1442-200X</identifier><identifier>DOI: 10.1111/ped.15360</identifier><identifier>PMID: 37026800</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>bronchopulmonary dysplasia ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infants ; Interactive Ventilatory Support ; invasive ventilator support ; Mechanical ventilation ; Neonates ; neurally adjusted ventilatory assist ; Newborn babies ; Oxygen ; Pediatrics ; Premature babies ; Prospective Studies ; Respiration, Artificial ; Respiratory distress syndrome ; Ventilators ; very low birth weight infant ; Weaning</subject><ispartof>Pediatrics international, 2023-01, Vol.65 (1), p.e15360-n/a</ispartof><rights>2022 Japan Pediatric Society.</rights><rights>2023 Japan Pediatric Society</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3770-a93483dab1759cb2af28f9ce34d7813b1016252ff84ecef3841063fab86b61ec3</citedby><cites>FETCH-LOGICAL-c3770-a93483dab1759cb2af28f9ce34d7813b1016252ff84ecef3841063fab86b61ec3</cites><orcidid>0000-0002-7788-214X ; 0000-0003-0208-7528 ; 0000-0002-3047-7702 ; 0000-0002-0218-2560 ; 0000-0002-6976-7096 ; 0000-0002-6369-4738 ; 0000-0003-0571-5956</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fped.15360$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fped.15360$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37026800$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fang, Shih‐Jou</creatorcontrib><creatorcontrib>Su, Chung‐Hao</creatorcontrib><creatorcontrib>Liao, Da‐Ling</creatorcontrib><creatorcontrib>Chen, Chih‐Cheng</creatorcontrib><creatorcontrib>Chung, Mei‐Yung</creatorcontrib><creatorcontrib>Chen, Feng‐Shun</creatorcontrib><creatorcontrib>Huang, Hsin‐Chun</creatorcontrib><creatorcontrib>Ou‐Yang, Mei‐Chen</creatorcontrib><title>Neurally adjusted ventilatory assist for rapid weaning in preterm infants</title><title>Pediatrics international</title><addtitle>Pediatr Int</addtitle><description>Background
Neurally adjusted ventilatory assist (NAVA) is a new mode of subject‐triggered ventilation. Experience with the use of NAVA in preterm infants is limited. This study compared the effects of invasive mechanical ventilation with NAVA to conventional intermittent mandatory ventilation (CIMV) in terms of reducing the duration of oxygen requirement and invasive ventilator support in preterm infants.
Methods
This was a prospective study. We enrolled infants of less than 32 weeks’ gestation who were then randomized to receive either NAVA or CIMV support during hospitalization. We recorded and analyzed data on the maternal history during pregnancy, use of medications, neonatal data at admission, neonatal diseases, and respiratory support in the neonatal intensive care unit.
Results
There were 26 preterm infants in the NAVA group and 27 preterm infants in the CIMV group. Significantly fewer infants in the NAVA group received supplemental oxygen at 28 days of age (12 [46%] vs. 21 [78%], p = 0.0365), and they required significantly fewer days of invasive ventilator support: 7.73 (± 2.39) vs. 17.26 (± 3.65), p = 0.0343.
Conclusions
Compared with CIMV, NAVA appears to allow for more rapid weaning from invasive ventilation and decreases the incidence of bronchopulmonary dysplasia, especially in preterm infants with severe respiratory distress syndrome treated with surfactants.</description><subject>bronchopulmonary dysplasia</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infants</subject><subject>Interactive Ventilatory Support</subject><subject>invasive ventilator support</subject><subject>Mechanical ventilation</subject><subject>Neonates</subject><subject>neurally adjusted ventilatory assist</subject><subject>Newborn babies</subject><subject>Oxygen</subject><subject>Pediatrics</subject><subject>Premature babies</subject><subject>Prospective Studies</subject><subject>Respiration, Artificial</subject><subject>Respiratory distress syndrome</subject><subject>Ventilators</subject><subject>very low birth weight infant</subject><subject>Weaning</subject><issn>1328-8067</issn><issn>1442-200X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE1Lw0AQhhdRbK0e_AMS8KKHtLO7SXZzlFo_oKgHBW_LJpmVlDSJu4ml_97VtBfBuczw8vAwvIScU5hSP7MWiymNeQIHZEyjiIUM4P3Q35zJUEIiRuTEuRUASCGjYzLiAlgiAcbk8Ql7q6tqG-hi1bsOi-AL666sdNdYHzpXui4wjQ2sbssi2KCuy_ojKOugtdihXfvT6Lpzp-TI6Mrh2W5PyNvd4nX-EC6f7x_nN8sw50JAqFMeSV7ojIo4zTOmDZMmzZFHhZCUZxRowmJmjIwwR8NlRCHhRmcyyRKKOZ-Qq8Hb2uazR9epdelyrCpdY9M7xUQqBWWxjD16-QddNb2t_XeKpZAwISUFT10PVG4b5ywa1dpyre1WUVA__Srfr_rt17MXO2OfrX26J_eFemA2AJuywu3_JvWyuB2U33jXg9Y</recordid><startdate>202301</startdate><enddate>202301</enddate><creator>Fang, Shih‐Jou</creator><creator>Su, Chung‐Hao</creator><creator>Liao, Da‐Ling</creator><creator>Chen, Chih‐Cheng</creator><creator>Chung, Mei‐Yung</creator><creator>Chen, Feng‐Shun</creator><creator>Huang, Hsin‐Chun</creator><creator>Ou‐Yang, Mei‐Chen</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7788-214X</orcidid><orcidid>https://orcid.org/0000-0003-0208-7528</orcidid><orcidid>https://orcid.org/0000-0002-3047-7702</orcidid><orcidid>https://orcid.org/0000-0002-0218-2560</orcidid><orcidid>https://orcid.org/0000-0002-6976-7096</orcidid><orcidid>https://orcid.org/0000-0002-6369-4738</orcidid><orcidid>https://orcid.org/0000-0003-0571-5956</orcidid></search><sort><creationdate>202301</creationdate><title>Neurally adjusted ventilatory assist for rapid weaning in preterm infants</title><author>Fang, Shih‐Jou ; Su, Chung‐Hao ; Liao, Da‐Ling ; Chen, Chih‐Cheng ; Chung, Mei‐Yung ; Chen, Feng‐Shun ; Huang, Hsin‐Chun ; Ou‐Yang, Mei‐Chen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3770-a93483dab1759cb2af28f9ce34d7813b1016252ff84ecef3841063fab86b61ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>bronchopulmonary dysplasia</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infants</topic><topic>Interactive Ventilatory Support</topic><topic>invasive ventilator support</topic><topic>Mechanical ventilation</topic><topic>Neonates</topic><topic>neurally adjusted ventilatory assist</topic><topic>Newborn babies</topic><topic>Oxygen</topic><topic>Pediatrics</topic><topic>Premature babies</topic><topic>Prospective Studies</topic><topic>Respiration, Artificial</topic><topic>Respiratory distress syndrome</topic><topic>Ventilators</topic><topic>very low birth weight infant</topic><topic>Weaning</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fang, Shih‐Jou</creatorcontrib><creatorcontrib>Su, Chung‐Hao</creatorcontrib><creatorcontrib>Liao, Da‐Ling</creatorcontrib><creatorcontrib>Chen, Chih‐Cheng</creatorcontrib><creatorcontrib>Chung, Mei‐Yung</creatorcontrib><creatorcontrib>Chen, Feng‐Shun</creatorcontrib><creatorcontrib>Huang, Hsin‐Chun</creatorcontrib><creatorcontrib>Ou‐Yang, Mei‐Chen</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fang, Shih‐Jou</au><au>Su, Chung‐Hao</au><au>Liao, Da‐Ling</au><au>Chen, Chih‐Cheng</au><au>Chung, Mei‐Yung</au><au>Chen, Feng‐Shun</au><au>Huang, Hsin‐Chun</au><au>Ou‐Yang, Mei‐Chen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neurally adjusted ventilatory assist for rapid weaning in preterm infants</atitle><jtitle>Pediatrics international</jtitle><addtitle>Pediatr Int</addtitle><date>2023-01</date><risdate>2023</risdate><volume>65</volume><issue>1</issue><spage>e15360</spage><epage>n/a</epage><pages>e15360-n/a</pages><issn>1328-8067</issn><eissn>1442-200X</eissn><abstract>Background
Neurally adjusted ventilatory assist (NAVA) is a new mode of subject‐triggered ventilation. Experience with the use of NAVA in preterm infants is limited. This study compared the effects of invasive mechanical ventilation with NAVA to conventional intermittent mandatory ventilation (CIMV) in terms of reducing the duration of oxygen requirement and invasive ventilator support in preterm infants.
Methods
This was a prospective study. We enrolled infants of less than 32 weeks’ gestation who were then randomized to receive either NAVA or CIMV support during hospitalization. We recorded and analyzed data on the maternal history during pregnancy, use of medications, neonatal data at admission, neonatal diseases, and respiratory support in the neonatal intensive care unit.
Results
There were 26 preterm infants in the NAVA group and 27 preterm infants in the CIMV group. Significantly fewer infants in the NAVA group received supplemental oxygen at 28 days of age (12 [46%] vs. 21 [78%], p = 0.0365), and they required significantly fewer days of invasive ventilator support: 7.73 (± 2.39) vs. 17.26 (± 3.65), p = 0.0343.
Conclusions
Compared with CIMV, NAVA appears to allow for more rapid weaning from invasive ventilation and decreases the incidence of bronchopulmonary dysplasia, especially in preterm infants with severe respiratory distress syndrome treated with surfactants.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>37026800</pmid><doi>10.1111/ped.15360</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-7788-214X</orcidid><orcidid>https://orcid.org/0000-0003-0208-7528</orcidid><orcidid>https://orcid.org/0000-0002-3047-7702</orcidid><orcidid>https://orcid.org/0000-0002-0218-2560</orcidid><orcidid>https://orcid.org/0000-0002-6976-7096</orcidid><orcidid>https://orcid.org/0000-0002-6369-4738</orcidid><orcidid>https://orcid.org/0000-0003-0571-5956</orcidid></addata></record> |
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| identifier | ISSN: 1328-8067 |
| ispartof | Pediatrics international, 2023-01, Vol.65 (1), p.e15360-n/a |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | bronchopulmonary dysplasia Humans Infant Infant, Newborn Infant, Premature Infants Interactive Ventilatory Support invasive ventilator support Mechanical ventilation Neonates neurally adjusted ventilatory assist Newborn babies Oxygen Pediatrics Premature babies Prospective Studies Respiration, Artificial Respiratory distress syndrome Ventilators very low birth weight infant Weaning |
| title | Neurally adjusted ventilatory assist for rapid weaning in preterm infants |
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