Application of Neurally Adjusted Ventilatory Assist in Premature Neonates Less Than 1,500 Grams With Established or Evolving Bronchopulmonary Dysplasia
Background: Very low birth weight premature (VLBW) infants with bronchopulmonary dysplasia (BPD) often need prolonged respiratory support, which is associated with worse outcomes. The application of neurally adjusted ventilatory assist ventilation (NAVA) in infants with BPD has rarely been reported....
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2020-03-01
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doaj-f12cfca6a88d41a3861c539071a3e1792020-11-25T02:07:58ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602020-03-01810.3389/fped.2020.00110510559Application of Neurally Adjusted Ventilatory Assist in Premature Neonates Less Than 1,500 Grams With Established or Evolving Bronchopulmonary DysplasiaXiao Rong0Feng Liang1Yuan-Jing Li2Hong Liang3Xiao-Peng Zhao4Hong-Mei Zou5Wei-Neng Lu6Hui Shi7Jing-Hua Zhang8Rui-Lian Guan9Yi Sun10Huayan Zhang11Huayan Zhang12Division of Neonatology, Guangzhou Women and Children's Medical Center Affiliated With Jinan University, Guanghzou, ChinaDivision of Neonatology, Guangzhou Women and Children's Medical Center, Guanghzou, ChinaDivision of Neonatology, Guangzhou Women and Children's Medical Center, Guanghzou, ChinaDivision of Neonatology, Guangzhou Women and Children's Medical Center, Guanghzou, ChinaDivision of Neonatology, Guangzhou Women and Children's Medical Center, Guanghzou, ChinaDivision of Neonatology, Guangzhou Women and Children's Medical Center, Guanghzou, ChinaDivision of Neonatology, Guangzhou Women and Children's Medical Center Affiliated With Jinan University, Guanghzou, ChinaDivision of Neonatology, Guangzhou Women and Children's Medical Center, Guanghzou, ChinaDivision of Neonatology, Guangzhou Women and Children's Medical Center, Guanghzou, ChinaDivision of Neonatology, Guangzhou Women and Children's Medical Center, Guanghzou, ChinaDivision of Neonatology, Guangzhou Women and Children's Medical Center, Guanghzou, ChinaDivision of Neonatology, Guangzhou Women and Children's Medical Center, Guanghzou, ChinaChildren's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United StatesBackground: Very low birth weight premature (VLBW) infants with bronchopulmonary dysplasia (BPD) often need prolonged respiratory support, which is associated with worse outcomes. The application of neurally adjusted ventilatory assist ventilation (NAVA) in infants with BPD has rarely been reported. This study investigated whether NAVA is safe and can reduce the duration respiratory support in VLBW premature infants with established or evolving BPD.Methods: This retrospective matched-cohort study included patients admitted to our NICU between April 2017 to April 2019 who were born at <32 weeks' gestation with birthweight of <1,500 g. The study groups (NAVA group) were infants who received NAVA ventilation as a sequel mode of ventilation after at least 2 weeks of traditional respiratory support after birth. The control group were preterm infants who required traditional respiratory support beyond first 2 weeks of life and were closely matched to the NAVA patients by gestational age and birthweight. The primary outcome was to compare the total duration of respiratory support between the NAVA group and the control group. The secondary outcomes were comparisons of duration of invasive and non-invasive support, oxygen therapy, length of stay, severity of BPD, weight gain and sedation need between the groups.Results: There were no significant differences between NAVA group and control group in the primary and most of the secondary outcomes (all P > 0.05). However, NAVA was well tolerated and there was a decrease in the need of sedation (p = 0.012) after switching to NAVA.Conclusion: NAVA, when used as a sequel mode of ventilation, in premature neonates <1,500 g with evolving or established BPD showed a similar effect compared to conventional ventilation in respiratory outcomes. NAVA can be safely used in this patient population and potentially can decrease the need of sedation.https://www.frontiersin.org/article/10.3389/fped.2020.00110/fullpremature infantsbronchopulmonary dysplasiaBPDneurally adjusted ventilatory assist ventilationNAVAvery low birth weight |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Xiao Rong Feng Liang Yuan-Jing Li Hong Liang Xiao-Peng Zhao Hong-Mei Zou Wei-Neng Lu Hui Shi Jing-Hua Zhang Rui-Lian Guan Yi Sun Huayan Zhang Huayan Zhang |
spellingShingle |
Xiao Rong Feng Liang Yuan-Jing Li Hong Liang Xiao-Peng Zhao Hong-Mei Zou Wei-Neng Lu Hui Shi Jing-Hua Zhang Rui-Lian Guan Yi Sun Huayan Zhang Huayan Zhang Application of Neurally Adjusted Ventilatory Assist in Premature Neonates Less Than 1,500 Grams With Established or Evolving Bronchopulmonary Dysplasia Frontiers in Pediatrics premature infants bronchopulmonary dysplasia BPD neurally adjusted ventilatory assist ventilation NAVA very low birth weight |
author_facet |
Xiao Rong Feng Liang Yuan-Jing Li Hong Liang Xiao-Peng Zhao Hong-Mei Zou Wei-Neng Lu Hui Shi Jing-Hua Zhang Rui-Lian Guan Yi Sun Huayan Zhang Huayan Zhang |
author_sort |
Xiao Rong |
title |
Application of Neurally Adjusted Ventilatory Assist in Premature Neonates Less Than 1,500 Grams With Established or Evolving Bronchopulmonary Dysplasia |
title_short |
Application of Neurally Adjusted Ventilatory Assist in Premature Neonates Less Than 1,500 Grams With Established or Evolving Bronchopulmonary Dysplasia |
title_full |
Application of Neurally Adjusted Ventilatory Assist in Premature Neonates Less Than 1,500 Grams With Established or Evolving Bronchopulmonary Dysplasia |
title_fullStr |
Application of Neurally Adjusted Ventilatory Assist in Premature Neonates Less Than 1,500 Grams With Established or Evolving Bronchopulmonary Dysplasia |
title_full_unstemmed |
Application of Neurally Adjusted Ventilatory Assist in Premature Neonates Less Than 1,500 Grams With Established or Evolving Bronchopulmonary Dysplasia |
title_sort |
application of neurally adjusted ventilatory assist in premature neonates less than 1,500 grams with established or evolving bronchopulmonary dysplasia |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Pediatrics |
issn |
2296-2360 |
publishDate |
2020-03-01 |
description |
Background: Very low birth weight premature (VLBW) infants with bronchopulmonary dysplasia (BPD) often need prolonged respiratory support, which is associated with worse outcomes. The application of neurally adjusted ventilatory assist ventilation (NAVA) in infants with BPD has rarely been reported. This study investigated whether NAVA is safe and can reduce the duration respiratory support in VLBW premature infants with established or evolving BPD.Methods: This retrospective matched-cohort study included patients admitted to our NICU between April 2017 to April 2019 who were born at <32 weeks' gestation with birthweight of <1,500 g. The study groups (NAVA group) were infants who received NAVA ventilation as a sequel mode of ventilation after at least 2 weeks of traditional respiratory support after birth. The control group were preterm infants who required traditional respiratory support beyond first 2 weeks of life and were closely matched to the NAVA patients by gestational age and birthweight. The primary outcome was to compare the total duration of respiratory support between the NAVA group and the control group. The secondary outcomes were comparisons of duration of invasive and non-invasive support, oxygen therapy, length of stay, severity of BPD, weight gain and sedation need between the groups.Results: There were no significant differences between NAVA group and control group in the primary and most of the secondary outcomes (all P > 0.05). However, NAVA was well tolerated and there was a decrease in the need of sedation (p = 0.012) after switching to NAVA.Conclusion: NAVA, when used as a sequel mode of ventilation, in premature neonates <1,500 g with evolving or established BPD showed a similar effect compared to conventional ventilation in respiratory outcomes. NAVA can be safely used in this patient population and potentially can decrease the need of sedation. |
topic |
premature infants bronchopulmonary dysplasia BPD neurally adjusted ventilatory assist ventilation NAVA very low birth weight |
url |
https://www.frontiersin.org/article/10.3389/fped.2020.00110/full |
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