title: Noninvasive Neurally Adjusted Ventilatory Assist in Premature Infants Postextubation.
abstract: BackgroundNeurally 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.ObjectiveTo determine whether synchronized noninvasive ventilation via neurally adjusted ventilatory assist (NIV NAVA) supports ventilation postextubation in premature infants.MethodsA retrospective analysis of a cohort of twenty-four former VLBW (<1.5 kg) infants from July 2011 to October 2012. Decreased or unchanged capillary pCO2after 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).ResultsVentilation improved after an increase in NIV NAVA level in 83% of the premature infants studied (20/24) with a decrease in median pCO2by 5 mm Hg (p= 0.0001).ConclusionNIV NAVA can provide synchronized postextubation ventilatory support as measured by decreased pCO2in premature infants.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Carver College of Medicine, Iowa City, Iowa.
authors.forename: Tarah T
authors.initials: TT
authors.lastname: Colaizy
authors.affiliation: Mercy Medical Center, Des Moines, Iowa.
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Kummet
authors.affiliation: Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Kummet
authors.affiliation: Division of Neonatology, Department of Pediatrics, Carver College of Medicine, Iowa City, Iowa.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Klein
mesh_terms: D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D059725:Interactive Ventilatory Support; D007484:Iowa; D008297:Male; D063087:Noninvasive Ventilation; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*; D012189:Retrospective Studies