Comparison of extubation success using noninvasive positive pressure ventilation (NIPPV) versus noninvasive neurally adjusted ventilatory assist (NI-NAVA)
Objective Compare rates of initial extubation success in preterm infants extubated to NIPPV or NI-NAVA. Study design In this pilot study, we randomized 30 mechanically ventilated preterm infants at the time of initial elective extubation to NI-NAVA or NIPPV in a 1:1 assignment. Primary study outcome...
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| Veröffentlicht in: | Journal of perinatology 2020-08, Vol.40 (8), p.1202-1210 |
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| container_title | Journal of perinatology |
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| creator | Makker, Kartikeya Cortez, Josef Jha, Kanishk Shah, Sanket Nandula, Padma Lowrie, David Smotherman, Carmen Gautam, Shiva Hudak, Mark L. |
| description | Objective
Compare rates of initial extubation success in preterm infants extubated to NIPPV or NI-NAVA.
Study design
In this pilot study, we randomized 30 mechanically ventilated preterm infants at the time of initial elective extubation to NI-NAVA or NIPPV in a 1:1 assignment. Primary study outcome was initial extubation success.
Results
Rates of continuous extubation for 120 h were 92% in the NI-NAVA group and 69% in the NIPPV group (12/13 vs. 9/13, respectively,
p
= 0.14). Infants extubated to NI-NAVA remained extubated longer (median 18 vs. 4 days,
p
= 0.02) and experienced lower peak inspiratory pressures (PIP) than infants managed with NIPPV throughout the first 3 days after extubation. Survival analysis through 14 days post extubation showed a sustained difference in the primary study outcome until 12 days post extubation.
Conclusions
Our study is the first to suggest that a strategy of extubating preterm infants to NI-NAVA may be more successful. |
| doi_str_mv | 10.1038/s41372-019-0578-4 |
| format | Article |
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Compare rates of initial extubation success in preterm infants extubated to NIPPV or NI-NAVA.
Study design
In this pilot study, we randomized 30 mechanically ventilated preterm infants at the time of initial elective extubation to NI-NAVA or NIPPV in a 1:1 assignment. Primary study outcome was initial extubation success.
Results
Rates of continuous extubation for 120 h were 92% in the NI-NAVA group and 69% in the NIPPV group (12/13 vs. 9/13, respectively,
p
= 0.14). Infants extubated to NI-NAVA remained extubated longer (median 18 vs. 4 days,
p
= 0.02) and experienced lower peak inspiratory pressures (PIP) than infants managed with NIPPV throughout the first 3 days after extubation. Survival analysis through 14 days post extubation showed a sustained difference in the primary study outcome until 12 days post extubation.
Conclusions
Our study is the first to suggest that a strategy of extubating preterm infants to NI-NAVA may be more successful.</description><identifier>ISSN: 0743-8346</identifier><identifier>EISSN: 1476-5543</identifier><identifier>DOI: 10.1038/s41372-019-0578-4</identifier><identifier>PMID: 31911641</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>692/308 ; 692/308/409 ; Airway Extubation ; Comparative analysis ; Extubation ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infants ; Infants (Premature) ; Interactive Ventilatory Support ; Mechanical ventilation ; Medicine ; Medicine & Public Health ; Neonates ; Neonatology ; Newborn babies ; Pediatric Surgery ; Pediatrics ; Pilot Projects ; Positive-Pressure Respiration ; Premature birth ; Respiration ; Respiratory therapy ; Success ; Survival analysis ; Ventilation</subject><ispartof>Journal of perinatology, 2020-08, Vol.40 (8), p.1202-1210</ispartof><rights>The Author(s), under exclusive licence to Springer Nature America, Inc. 2020</rights><rights>COPYRIGHT 2020 Nature Publishing Group</rights><rights>The Author(s), under exclusive licence to Springer Nature America, Inc. 2020.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c529t-ef0b3c3bfc26ce05524f3cb0a08e1a5f8e1edee13b6a0d36f97f7abf20c4e6993</citedby><cites>FETCH-LOGICAL-c529t-ef0b3c3bfc26ce05524f3cb0a08e1a5f8e1edee13b6a0d36f97f7abf20c4e6993</cites><orcidid>0000-0001-9405-3522</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/s41372-019-0578-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/s41372-019-0578-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31911641$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Makker, Kartikeya</creatorcontrib><creatorcontrib>Cortez, Josef</creatorcontrib><creatorcontrib>Jha, Kanishk</creatorcontrib><creatorcontrib>Shah, Sanket</creatorcontrib><creatorcontrib>Nandula, Padma</creatorcontrib><creatorcontrib>Lowrie, David</creatorcontrib><creatorcontrib>Smotherman, Carmen</creatorcontrib><creatorcontrib>Gautam, Shiva</creatorcontrib><creatorcontrib>Hudak, Mark L.</creatorcontrib><title>Comparison of extubation success using noninvasive positive pressure ventilation (NIPPV) versus noninvasive neurally adjusted ventilatory assist (NI-NAVA)</title><title>Journal of perinatology</title><addtitle>J Perinatol</addtitle><addtitle>J Perinatol</addtitle><description>Objective
Compare rates of initial extubation success in preterm infants extubated to NIPPV or NI-NAVA.
Study design
In this pilot study, we randomized 30 mechanically ventilated preterm infants at the time of initial elective extubation to NI-NAVA or NIPPV in a 1:1 assignment. Primary study outcome was initial extubation success.
Results
Rates of continuous extubation for 120 h were 92% in the NI-NAVA group and 69% in the NIPPV group (12/13 vs. 9/13, respectively,
p
= 0.14). Infants extubated to NI-NAVA remained extubated longer (median 18 vs. 4 days,
p
= 0.02) and experienced lower peak inspiratory pressures (PIP) than infants managed with NIPPV throughout the first 3 days after extubation. Survival analysis through 14 days post extubation showed a sustained difference in the primary study outcome until 12 days post extubation.
Conclusions
Our study is the first to suggest that a strategy of extubating preterm infants to NI-NAVA may be more successful.</description><subject>692/308</subject><subject>692/308/409</subject><subject>Airway Extubation</subject><subject>Comparative analysis</subject><subject>Extubation</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infants</subject><subject>Infants (Premature)</subject><subject>Interactive Ventilatory Support</subject><subject>Mechanical ventilation</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neonates</subject><subject>Neonatology</subject><subject>Newborn babies</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Pilot Projects</subject><subject>Positive-Pressure Respiration</subject><subject>Premature birth</subject><subject>Respiration</subject><subject>Respiratory therapy</subject><subject>Success</subject><subject>Survival 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China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of perinatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Makker, Kartikeya</au><au>Cortez, Josef</au><au>Jha, Kanishk</au><au>Shah, Sanket</au><au>Nandula, Padma</au><au>Lowrie, David</au><au>Smotherman, Carmen</au><au>Gautam, Shiva</au><au>Hudak, Mark L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of extubation success using noninvasive positive pressure ventilation (NIPPV) versus noninvasive neurally adjusted ventilatory assist (NI-NAVA)</atitle><jtitle>Journal of perinatology</jtitle><stitle>J Perinatol</stitle><addtitle>J Perinatol</addtitle><date>2020-08-01</date><risdate>2020</risdate><volume>40</volume><issue>8</issue><spage>1202</spage><epage>1210</epage><pages>1202-1210</pages><issn>0743-8346</issn><eissn>1476-5543</eissn><abstract>Objective
Compare rates of initial extubation success in preterm infants extubated to NIPPV or NI-NAVA.
Study design
In this pilot study, we randomized 30 mechanically ventilated preterm infants at the time of initial elective extubation to NI-NAVA or NIPPV in a 1:1 assignment. Primary study outcome was initial extubation success.
Results
Rates of continuous extubation for 120 h were 92% in the NI-NAVA group and 69% in the NIPPV group (12/13 vs. 9/13, respectively,
p
= 0.14). Infants extubated to NI-NAVA remained extubated longer (median 18 vs. 4 days,
p
= 0.02) and experienced lower peak inspiratory pressures (PIP) than infants managed with NIPPV throughout the first 3 days after extubation. Survival analysis through 14 days post extubation showed a sustained difference in the primary study outcome until 12 days post extubation.
Conclusions
Our study is the first to suggest that a strategy of extubating preterm infants to NI-NAVA may be more successful.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>31911641</pmid><doi>10.1038/s41372-019-0578-4</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-9405-3522</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0743-8346 |
| ispartof | Journal of perinatology, 2020-08, Vol.40 (8), p.1202-1210 |
| issn | 0743-8346 1476-5543 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7222927 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | 692/308 692/308/409 Airway Extubation Comparative analysis Extubation Humans Infant Infant, Newborn Infant, Premature Infants Infants (Premature) Interactive Ventilatory Support Mechanical ventilation Medicine Medicine & Public Health Neonates Neonatology Newborn babies Pediatric Surgery Pediatrics Pilot Projects Positive-Pressure Respiration Premature birth Respiration Respiratory therapy Success Survival analysis Ventilation |
| title | Comparison of extubation success using noninvasive positive pressure ventilation (NIPPV) versus noninvasive neurally adjusted ventilatory assist (NI-NAVA) |
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