Neurally adjusted ventilatory assist in neonates with congenital diaphragmatic hernia
Y Kurland, K Gurung, EK Pallotto, W Manimtim… - Journal of …, 2021 - nature.com
Journal of Perinatology, 2021•nature.com
Objective To measure short-term outcomes of neonates with congenital diaphragmatic
hernia (CDH) while on Neurally Adjusted Ventilator Assist (NAVA), and to measure the
impact of a congenitally abnormal diaphragm on NAVA ventilator indices. Study design First,
we conducted a retrospective-cohort analysis of 16 neonates with CDH placed on NAVA
over a treatment period of 72 h. Second, we performed a case–control study comparing
NAVA level and Edi between neonates with CDH and those without CDH. Results …
hernia (CDH) while on Neurally Adjusted Ventilator Assist (NAVA), and to measure the
impact of a congenitally abnormal diaphragm on NAVA ventilator indices. Study design First,
we conducted a retrospective-cohort analysis of 16 neonates with CDH placed on NAVA
over a treatment period of 72 h. Second, we performed a case–control study comparing
NAVA level and Edi between neonates with CDH and those without CDH. Results …
Objective
To measure short-term outcomes of neonates with congenital diaphragmatic hernia (CDH) while on Neurally Adjusted Ventilator Assist (NAVA), and to measure the impact of a congenitally abnormal diaphragm on NAVA ventilator indices.
Study design
First, we conducted a retrospective-cohort analysis of 16 neonates with CDH placed on NAVA over a treatment period of 72 h. Second, we performed a case–control study comparing NAVA level and Edi between neonates with CDH and those without CDH.
Results
Compared to pre-NAVA, there were clinically meaningful improvements in PIP (p < 0.003), Respiratory Severity Score (p < 0.001), MAP (p < 0.001), morphine (p = 0.004), and midazolam use (p = 0.037). Compared to a 1:2 matched group without CDH, there was no meaningful difference in NAVA level (p = 0.286), Edi-Peak (p = 0.315), or Edi-Min (p = 0.266).
Conclusions
The potential benefits of NAVA extend to neonates with CDH. There is minimal compensatory change in Edis, and higher/lower ventilator settings compared to neonates without CDH.
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