Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun;75(3):347-353.
doi: 10.23736/S2724-5276.19.05142-9. Epub 2019 Apr 5.

Weaning in neurally adjusted ventilatory assist: a prospective interventional study in neonates

Gianluca Cosi  1 , Alice Monzani  2 , Giulia Genoni  3 , Simona DE Franco  1 , Silvia Parlamento  2 , Gianni Bona  2 , Federica Ferrero  1
Affiliations

Weaning in neurally adjusted ventilatory assist: a prospective interventional study in neonates

Gianluca Cosi et al. Minerva Pediatr (Torino). 2023 Jun.

Abstract

Background: Neurally adjusted ventilatory assist (NAVA) is a respiratory support triggered by the electrical activity of the diaphragm (EAdi). Only few studies evaluated NAVA short-term efficacy and safety in newborns. Aim of this study was to assess efficacy and safety of NAVA in a cohort of newborns and to analyze ventilation parameters helpful to guide weaning.

Methods: Thirty-four newborns with respiratory failure were ventilated with synchronized intermittent mandatory ventilation plus pressure-regulated volume control plus pressure support (SIMV(PRVC)+PS) for 12 hours and switched to NAVA until extubation. Ventilator and vital parameters, oxygen saturation (SpO2)/fraction of inspired oxygen (FiO2) ratio (S/F), arterialized capillary blood gases (aCBG), and sedatives dose were recorded. The occurrence of reintubation within the first 72 hours, pneumothorax and mortality were evaluated.

Results: After 6 hours of NAVA, a significant reduction of FiO2 (0.25 versus 0.32), and peak inspiratory pressure (13 versus 18 mmHg), and a significant increase of S/F (383 versus 316) were found, compared to SIMV(PRVC)+PS. Other ventilation, vital and aCBG parameters were similar in both ventilation modes. During NAVA a significant reduction of sedation was shown. All subjects were successfully extubated guided by EAdi peak during weaning. No reintubation, pneumothorax, or death were recorded.

Conclusions: NAVA can be effectively and safely used in neonates. The EAdi peak could be a reliable index to guide the physicians during weaning and extubation.

PubMed Disclaimer