Comparison of NIV-NAVA and NCPAP in facilitating extubation for very preterm infants

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dc.contributor.authorLee, Byoung Kook-
dc.contributor.authorShin, Seung Han-
dc.contributor.authorJung, Young Hwa-
dc.contributor.authorKim, Ee-Kyung-
dc.contributor.authorKim, Han-Suk-
dc.identifier.citationBMC Pediatrics, 19(1):298ko_KR
Various types of noninvasive respiratory modalities that lead to successful extubation in preterm infants have been explored. We aimed to compare noninvasive neurally adjusted ventilatory assist (NIV-NAVA) and nasal continuous positive airway pressure (NCPAP) for the postextubation stabilization of preterm infants.

This retrospective study was divided into two distinct periods, between July 2012 and June 2013 and between July 2013 and June 2014, because NIV-NAVA was applied beginning in July 2013. Preterm infants of less than 30 weeks GA who had been intubated with mechanical ventilation for longer than 24 h and were weaned to NCPAP or NIV-NAVA after extubation were enrolled. Ventilatory variables and extubation failure were compared after weaning to NCPAP or NIV-NAVA. Extubation failure was defined when infants were reintubated within 72 h of extubation.

There were 14 infants who were weaned to NCPAP during Period I, and 2 infants and 16 infants were weaned to NCPAP and NIV-NAVA, respectively, during Period II. At the time of extubation, there were no differences in the respiratory severity score (NIV-NAVA 1.65 vs. NCPAP 1.95), oxygen saturation index (1.70 vs. 2.09) and steroid use before extubation. Several ventilation parameters at extubation, such as the mean airway pressure, positive end-expiratory pressure, peak inspiratory pressure, and FiO2, were similar between the two groups. SpO2 and pCO2 preceding extubation were comparable. Extubation failure within 72 h after extubation was observed in 6.3% of the NIV-NAVA group and 37.5% of the NCPAP group (P = 0.041).

The data in the present showed promising implications for using NIV-NAVA over NCPAP to facilitate extubation.
dc.description.sponsorshipThis study was supported by a grant from the Seoul National University Hospital Research Fund (04–2015-0430) and by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2017R1D1A1B03036383). The funders did not participate in the research, or in the preparation the manuscript.ko_KR
dc.publisherBioMed Centralko_KR
dc.subjectAirway extubationko_KR
dc.subjectContinuous positive airway pressure, Neurally adjusted ventilator assistko_KR
dc.subjectNoninvasive ventilationko_KR
dc.subjectVentilator weaningko_KR
dc.titleComparison of NIV-NAVA and NCPAP in facilitating extubation for very preterm infantsko_KR
dc.rights.holderThe Author(s).-
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College of Medicine/School of Medicine (의과대학/대학원)Pediatrics (소아과학전공)Journal Papers (저널논문_소아과학전공)
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