Noninvasive Neurally Adjusted Ventilation in Postextubation Stabilization of Preterm Infants: A Randomized Controlled Study - 01/09/22
Abstract |
Objective |
To compare the effects of noninvasive neurally adjusted ventilatory assist (NIV-NAVA) to nasal continuous positive airway pressure (NCPAP) in achieving successful extubation in preterm infants.
Study design |
This prospective, single-center, randomized controlled trial enrolled preterm infants born at <30 weeks of gestation who received invasive ventilation. Participants were assigned at random to either NIV-NAVA or NCPAP after their first extubation from invasive ventilation. The primary outcome of the study was extubation failure within 72 hours of extubation. Electrical activity of the diaphragm (Edi) values were collected before extubation and at 1, 4, 12, and 24 hours after extubation.
Results |
A total of 78 infants were enrolled, including 35 infants in the NIV-NAVA group and 35 infants in the NCPAP group. Extubation failure within 72 hours of extubation was higher in the NCPAP group than in the NIV-NAVA group (28.6% vs 8.6%; P = .031). The duration of respiratory support and incidence of severe bronchopulmonary dysplasia were similar in the 2 groups. Peak and swing Edi values were comparable before and at 1 hour after extubation, but values at 4, 12, and 24 hours after extubation were lower in the NIV-NAVA group compared with the NCPAP group.
Conclusions |
In the present trial, NIV-NAVA was more effective than NCPAP in preventing extubation failure in preterm infants.
Trial registration |
ClinicalTrials.gov: NCT02590757.
Le texte complet de cet article est disponible en PDF.Keywords : neurally adjusted ventilatory assist, nasal continuous positive airway pressure, noninvasive ventilation, preterm infants, weaning, extubation
Abbreviations : BPD, Edi, FiO2, NAVA, NCPAP, NIPPV, NIV, pCO2, PEEP, RCT, SpO2, WOB
Plan
| This study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (Grant NRF-2020R1F1A1077268). The authors declare no conflicts of interest. |
Vol 247
P. 53 - août 2022 Retour au numéro
Article précédent
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