4.6 Article

Evaluating peak inspiratory pressures and tidal volume in premature neonates on NAVA ventilation

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EUROPEAN JOURNAL OF PEDIATRICS
卷 180, 期 1, 页码 167-175

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SPRINGER
DOI: 10.1007/s00431-020-03728-y

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Neurally adjusted ventilatory assist (NAVA); Premature neonates; Ventilatory induced lung injury; Tidal volume; Peak pressure

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In neonates on NAVA, most pressures and volumes were within or lower than recommended ranges with pressure-limited or volume-guarantee ventilation.
Neurally adjusted ventilatory assist (NAVA) ventilation allows patients to determine their peak inspiratory pressure and tidal volume on a breath-by-breath basis. Apprehension exists about premature neonates' ability to self-regulate breath size. This study describes peak pressure and tidal volume distribution of neonates on NAVA and non-invasive NAVA. This is a retrospective study of stored ventilator data with exploratory analysis. Summary statistics were calculated. Distributional assessment of peak pressure and tidal volume were evaluated, overall and per NAVA level. Over 1 million breaths were evaluated from 56 subjects. Mean peak pressure was 16.4 +/- 6.4 in the NAVA group, and 15.8 +/- 6.4 in the NIV-NAVA group (t test, p < 0.001). Mean tidal volume was 3.5 +/- 2.7 ml/kg. Conclusion:In neonates on NAVA, most pressures and volumes were within or lower than recommended ranges with pressure-limited or volume-guarantee ventilation.

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