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

Cited 9 time in Web of Science Cited 9 time in Scopus
Authors
Lee, Byoung Kook; Shin, Seung Han; Jung, Young Hwa; Kim, Ee-Kyung; Kim, Han-Suk
Issue Date
2019-08-28
Publisher
BioMed Central
Citation
BMC Pediatrics, 19(1):298
Keywords
Airway extubationContinuous positive airway pressure, Neurally adjusted ventilator assistNoninvasive ventilationVentilator weaning
Abstract
Background
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.

Methods
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.

Results
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).

Conclusions
The data in the present showed promising implications for using NIV-NAVA over NCPAP to facilitate extubation.
ISSN
1471-2431
Language
English
URI
https://hdl.handle.net/10371/162630
DOI
https://doi.org/10.1186/s12887-019-1683-4
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College of Medicine/School of Medicine (의과대학/대학원)Pediatrics (소아과학전공)Journal Papers (저널논문_소아과학전공)
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