PDF(Pubmed)
Abstract：
BACKGROUND: Preterm infants often require non-invasive breathing support while their lungs and control of respiration are still developing. Non-invasive neurally adjusted ventilatory assist (NIV-NAVA) is an emerging technology that allows infants to breathe spontaneously while receiving support breaths proportional to their effort. This study describes the first Australian Neonatal Intensive Care Unit (NICU) experience of NIV-NAVA.
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.
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.
摘要：
背景：早产儿通常需要无创呼吸支持，而他们的肺和呼吸控制仍在发育中。非侵入性神经调节通气辅助(NIV-NAVA)是一种新兴技术,其允许婴儿自主呼吸,同时接受与其努力成比例的支持呼吸。这项研究描述了澳大利亚新生儿重症监护病房（NICU）对NIV-NAVA的首次体验。
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。
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。
