In a randomized controlled study, the findings of which were recently published in The Journal of Pediatrics, the researchers sought to compare the non-invasive neural ventilation method Neurally adjusted ventilator assistJ(NIV-NAVA) and nasal continuous positive airway pressure (NCPAP). The comparison was performed in preterm infants after successful extubation.
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Premature infants who were born before 30 weeks and treated with invasive ventilation participated in this prospective, single-center study. Subjects were randomly assigned to the NCPAP and NIV-NAVA groups immediately after successful extubation. The primary outcome of the study was extubation failure 72 hours after its performance. Electrical activity of the diaphragm (Edi) data was collected before extubation and at times of 1 hour, 4 hours, 12 hours and 24 hours after it.
The results of the study demonstrated that of the 78 premature infants who were recruited for the study, 35 were assigned to the NIV-NAVA group and 35 to the NCPAP group. In the NCPAP group, there were more extubation failures at 72 hours (28.6% vs. 8.6%, P = .031). Comparing the two groups, the duration of respiratory support and the number of severe bronchopulmonary dysplasia events were equal. The different Edi values were equal between the groups before extubation and one hour after extubation, however, at times 4, 12 and 24 hours after extubation these data were lower in the NIV-NAVA group, compared to the NCPAP group.
The results of this study show that comparing the methods, the NIV-NAVA ventilation method demonstrated a higher efficiency than the NCPAP method in preventing extubation failure in premature infants.
source:
Kotaniemi-Syrjänen, A., Klemola, T., Koponen, P., Jauhola, O., Aito, H., Malmström, K., … & Mäkelä, MJ (2022). Intermittent tiotropium bromide for episodic wheezing: a randomized trial. Pediatrics, 150(3).