METHODS: Retrospective cohort study of infants admitted to a major tertiary NICU between October 2017 and April 2021 supported with NIV-NAVA. Infants were divided into three groups based on the indication to initiate NIV-NAVA (post-extubation; apnoea; escalation). Successful application of NIV-NAVA was based on the need for re-intubation within 48 h of application.
RESULTS: There were 169 NIV-NAVA episodes in 122 infants (82 post-extubation; 21 apnoea; 66 escalation). The median (range) gestational age at birth was 25 + 5 weeks (23 + 1 to 43 + 3 weeks) and median (range) birthweight was 963 g (365-4320 g). At NIV-NAVA application, mean (SD) age was 17 days (18.2), and median (range) weight was 850 g (501-4310 g). Infants did not require intubation within 48 h in 145/169 (85.2%) episodes [72/82 (87.8%) extubation; 21/21 (100%) apnoea; 52/66 (78.8%) escalation).
CONCLUSIONS: NIV-NAVA was successfully integrated for the three main indications (escalation; post-extubation; apnoea). Prospective clinical trials are still required to establish its effectiveness versus other modes of non-invasive support.
方法:在NIV-NAVA支持下,对2017年10月至2021年4月间入住主要三级NICU的婴儿进行回顾性队列研究。根据启动NIV-NAVA(拔管后;呼吸暂停;升级)的适应症,将婴儿分为三组。NIV-NAVA的成功应用是基于在应用后48小时内重新插管的需要。
结果:在122例婴儿中,有169例NIV-NAVA发作(82例拔管后;21例呼吸暂停;66例升级)。出生时的中位(范围)胎龄为25+5周(23+1至43+3周),中位(范围)出生体重为963g(365-4320g)。在NIV-NAVA申请中,平均(SD)年龄为17天(18.2),和中位数(范围)重量为850g(501-4310g)。在145/169(85.2%)次发作中,婴儿在48小时内不需要插管[72/82(87.8%)拔管;21/21(100%)呼吸暂停;52/66(78.8%)上升)。
结论:NIV-NAVA成功整合了三个主要适应症(升级;拔管后;呼吸暂停)。与其他非侵入性支持模式相比,仍需要前瞻性临床试验来确定其有效性。