Makker K, Cortez J, Jha K, Shah S, Nandula P, Lowrie D, Smotherman C, Gautam S, Hudak ML. Comparison of extubation success using noninvasive positive pressure ventilation (NIPPV) versus noninvasive neurally adjusted ventilatory assist (NI-NAVA).
J Perinatol 2020;
40:1202-1210. [PMID:
31911641 PMCID:
PMC7222927 DOI:
10.1038/s41372-019-0578-4]
[Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/18/2019] [Accepted: 12/18/2019] [Indexed: 12/02/2022]
Abstract
OBJECTIVE
Compare rates of initial extubation success in preterm infants extubated to NIPPV or NI-NAVA.
STUDY DESIGN
In this pilot study, we randomized 30 mechanically ventilated preterm infants at the time of initial elective extubation to NI-NAVA or NIPPV in a 1:1 assignment. Primary study outcome was initial extubation success.
RESULTS
Rates of continuous extubation for 120 h were 92% in the NI-NAVA group and 69% in the NIPPV group (12/13 vs. 9/13, respectively, p = 0.14). Infants extubated to NI-NAVA remained extubated longer (median 18 vs. 4 days, p = 0.02) and experienced lower peak inspiratory pressures (PIP) than infants managed with NIPPV throughout the first 3 days after extubation. Survival analysis through 14 days post extubation showed a sustained difference in the primary study outcome until 12 days post extubation.
CONCLUSIONS
Our study is the first to suggest that a strategy of extubating preterm infants to NI-NAVA may be more successful.
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