NIV-NAVA versus NCPAP immediately after birth in premature infants: A randomized controlled trial

Respir Physiol Neurobiol. 2022 Aug:302:103916. doi: 10.1016/j.resp.2022.103916. Epub 2022 Apr 29.

Abstract

Objective: To evaluate whether noninvasive-neurally adjusted ventilatory assist (NIV-NAVA) decrease respiratory efforts compared to nasal continuous positive airway pressure (NCPAP) during the first hours of life.

Methods: Twenty infants born between 28+0 and 31+6 weeks were randomized to NIV-NAVA or NCPAP. Positive end-expiratory pressure was constantly kept at 6 cmH2O for both groups and the NAVA level was 1.0 cmH2O/µV for NIV-NAVA group. The electrical activity of diaphragm (Edi) were recorded for the first two hours.

Results: Peak and minimum Edi decreased similarly in both groups (P = 0.98 and P = 0.59, respectively). Leakages were higher in the NIV-NAVA group than in the NCPAP group (P < 0.001). The neural apnea defined as a flat Edi for ≥ 5 s were less frequent in NIV-NAVA group than in NCPAP group (P = 0.046).

Conclusions: Immediately applied NIV-NAVA in premature infants did not reduce breathing effort, measured as peak Edi. However, NIV-NAVA decreased neural apneic episodes compared to NCPAP.

Keywords: Apnea; Continuous positive airway pressure; Interactive ventilatory support; Non-invasive ventilation.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Continuous Positive Airway Pressure
  • Diaphragm
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Interactive Ventilatory Support*
  • Noninvasive Ventilation*