Abstract：
OBJECTIVE: To analyse the evidence of non-invasive neurally adjusted ventilatory assist (NIV-NAVA) in preterm neonates compared to nasal continuous positive airway pressure (nCPAP) or nasal intermittent positive pressure ventilation (NIPPV).
METHODS: We performed a systematic review and meta-analysis of randomised controlled trials and included studies where NIV-NAVA was analysed in preterm (<37 gestational weeks) born neonates. Our main outcomes were the need for endotracheal intubation, the need for surfactant therapy, and reintubation rates. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated.
RESULTS: A total of five studies were included. The endotracheal intubation rate was 25% in the NIV-NAVA group and 26% in the nCPAP group (RR 0.91, CI: 0.56-1.48). The respective rates for surfactant therapy were 30% and 35% (RR 0.85, CI: 0.56-1.29). The reintubation rate in neonates previously invasively ventilated was 8% in the NIV-NAVA group and 29% in the nCPAP/NIPPV group (RR 0.29, 95%CI: 0.10-0.81). Evidence certainty was rated as low for all outcomes.
CONCLUSIONS: NIV-NAVA as the primary respiratory support did not reduce the need for endotracheal intubation or surfactant therapy. NIV-NAVA seemed to reduce the reintubation rate after extubation in pre-term neonates.
METHODS: We performed a systematic review and meta-analysis of randomised controlled trials and included studies where NIV-NAVA was analysed in preterm (<37 gestational weeks) born neonates. Our main outcomes were the need for endotracheal intubation, the need for surfactant therapy, and reintubation rates. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated.
RESULTS: A total of five studies were included. The endotracheal intubation rate was 25% in the NIV-NAVA group and 26% in the nCPAP group (RR 0.91, CI: 0.56-1.48). The respective rates for surfactant therapy were 30% and 35% (RR 0.85, CI: 0.56-1.29). The reintubation rate in neonates previously invasively ventilated was 8% in the NIV-NAVA group and 29% in the nCPAP/NIPPV group (RR 0.29, 95%CI: 0.10-0.81). Evidence certainty was rated as low for all outcomes.
CONCLUSIONS: NIV-NAVA as the primary respiratory support did not reduce the need for endotracheal intubation or surfactant therapy. NIV-NAVA seemed to reduce the reintubation rate after extubation in pre-term neonates.
摘要：
目的：分析与经鼻持续气道正压通气（nCPAP）或经鼻间歇正压通气（NIPPV）相比，早产儿无创神经调节通气辅助（NIV-NAVA）的证据。
方法：我们对随机对照试验进行了系统评价和荟萃分析，并纳入了在早产（<37孕周）新生儿中分析NIV-NAVA的研究。我们的主要结果是需要气管插管，需要表面活性剂治疗，和再插管率。计算具有95%置信区间(CI)的风险比(RR)。
结果：共纳入5项研究。NIV-NAVA组气管插管率为25％，nCPAP组为26％（RR0.91，CI：0.56-1.48）。表面活性剂治疗的比率分别为30%和35%(RR0.85,CI:0.56-1.29)。NIV-NAVA组有创通气新生儿的再插管率为8%，nCPAP/NIPPV组为29%(RR0.29,95CI:0.10-0.81)。所有结果的证据确定性都被评为低。
结论：NIV-NAVA作为主要的呼吸支持并没有减少气管插管或表面活性剂治疗的需要。NIV-NAVA似乎降低了早产儿拔管后的再插管率。
方法：我们对随机对照试验进行了系统评价和荟萃分析，并纳入了在早产（<37孕周）新生儿中分析NIV-NAVA的研究。我们的主要结果是需要气管插管，需要表面活性剂治疗，和再插管率。计算具有95%置信区间(CI)的风险比(RR)。
结果：共纳入5项研究。NIV-NAVA组气管插管率为25％，nCPAP组为26％（RR0.91，CI：0.56-1.48）。表面活性剂治疗的比率分别为30%和35%(RR0.85,CI:0.56-1.29)。NIV-NAVA组有创通气新生儿的再插管率为8%，nCPAP/NIPPV组为29%(RR0.29,95CI:0.10-0.81)。所有结果的证据确定性都被评为低。
结论：NIV-NAVA作为主要的呼吸支持并没有减少气管插管或表面活性剂治疗的需要。NIV-NAVA似乎降低了早产儿拔管后的再插管率。
