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Comparative Study
. 2019 Aug 28;19(1):298.
doi: 10.1186/s12887-019-1683-4.

Comparison of NIV-NAVA and NCPAP in facilitating extubation for very preterm infants

Byoung Kook Lee  1 , Seung Han Shin  2   3 , Young Hwa Jung  4   5 , Ee-Kyung Kim  4   6 , Han-Suk Kim  4   6
Affiliations
Comparative Study

Comparison of NIV-NAVA and NCPAP in facilitating extubation for very preterm infants

Byoung Kook Lee et al. BMC Pediatr. .

Abstract

Background: Various types of noninvasive respiratory modalities that lead to successful extubation in preterm infants have been explored. We aimed to compare noninvasive neurally adjusted ventilatory assist (NIV-NAVA) and nasal continuous positive airway pressure (NCPAP) for the postextubation stabilization of preterm infants.

Methods: This retrospective study was divided into two distinct periods, between July 2012 and June 2013 and between July 2013 and June 2014, because NIV-NAVA was applied beginning in July 2013. Preterm infants of less than 30 weeks GA who had been intubated with mechanical ventilation for longer than 24 h and were weaned to NCPAP or NIV-NAVA after extubation were enrolled. Ventilatory variables and extubation failure were compared after weaning to NCPAP or NIV-NAVA. Extubation failure was defined when infants were reintubated within 72 h of extubation.

Results: There were 14 infants who were weaned to NCPAP during Period I, and 2 infants and 16 infants were weaned to NCPAP and NIV-NAVA, respectively, during Period II. At the time of extubation, there were no differences in the respiratory severity score (NIV-NAVA 1.65 vs. NCPAP 1.95), oxygen saturation index (1.70 vs. 2.09) and steroid use before extubation. Several ventilation parameters at extubation, such as the mean airway pressure, positive end-expiratory pressure, peak inspiratory pressure, and FiO2, were similar between the two groups. SpO2 and pCO2 preceding extubation were comparable. Extubation failure within 72 h after extubation was observed in 6.3% of the NIV-NAVA group and 37.5% of the NCPAP group (P = 0.041).

Conclusions: The data in the present showed promising implications for using NIV-NAVA over NCPAP to facilitate extubation.

Keywords: Airway extubation; Continuous positive airway pressure; Neurally adjusted ventilator assist; Noninvasive ventilation; Ventilator weaning.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Selection of the study population during the study period
Fig. 2
Fig. 2
Kaplan-Meier estimates for extubation success by post-extubation modality
See this image and copyright information in PMC

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