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Multicenter Experie...
Multicenter Experience with Neurally Adjusted Ventilatory Assist in Infants with Severe Bronchopulmonary Dysplasia
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- McKinney, Robin L. (author)
- Brown Univ, Hasbro Childrens Hosp, Dept Pediat Crit Care Med, Alpert Med Sch, 593 Eddy St, Potter 115, Providence, RI 02903 USA
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- Keszler, Martin (author)
- Brown Univ, Women & Infants Hosp, Dept Pediat, Alpert Med Sch, Providence, RI 02903 USA
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- Truog, William E. (author)
- Univ Missouri, Dept Pediat, Childrens Mercy Kansas City, Sch Med, Kansas City, MO 64110 USA
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- Norberg, Michael (author)
- Childrens Mercy Hosp, Dept Neonatol, Kansas City, MO 64108 USA
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- Sindelar, Richard, Docent, 1964- (author)
- Uppsala universitet,Perinatal, neonatal och barnkardiologisk forskning
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- Wallström, Linda, 1973- (author)
- Uppsala universitet,Perinatal, neonatal och barnkardiologisk forskning
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- Schulman, Bruce (author)
- Joe DiMaggio Childrens Hosp, Dept Neonatol, Hollywood, FL USA
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- Gien, Jason (author)
- Univ Colorado, Dept Pediat, Anschutz Med Ctr, Aurora, CO USA.;Childrens Hosp Colorado, Aurora, CO USA
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- Abman, Steven H. (author)
- Univ Colorado, Dept Pediat, Anschutz Med Ctr, Aurora, CO USA.;Childrens Hosp Colorado, Aurora, CO USA
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(creator_code:org_t)
- 2020-03-24
- 2021
- English.
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In: American Journal of Perinatology. - : Georg Thieme Verlag KG. - 0735-1631 .- 1098-8785. ; 38, s. E162-E166
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Objective The aim of this study is to determine patterns of neurally adjusted ventilatory assist (NAVA) use in ventilator-dependent preterm infants with evolving or established severe bronchopulmonary dysplasia (sBPD) among centers of the BPD Collaborative, including indications for its initiation, discontinuation, and outcomes.Study Design Retrospective review of infants with developing or established sBPD who were placed on NAVA after ≥4 weeks of mechanical ventilation and were ≥ 30 weeks of postmenstrual age (PMA).Results Among the 13 sites of the BPD collaborative, only four centers (31%) used NAVA in the management of infants with evolving or established BPD. A total of 112 patients met inclusion criteria from these four centers. PMA, weight at the start of NAVA and median number of days on NAVA, were different among the four centers. The impact of NAVA therapy was assessed as being successful in 67% of infants, as defined by the ability to achieve respiratory stability at a lower level of ventilator support, including extubation to noninvasive positive pressure ventilation or support with a home ventilator. In total 87% (range: 78–100%) of patients survived until discharge.Conclusion We conclude that NAVA can be used safely and effectively in selective infants with sBPD. Indications and current strategies for the application of NAVA in infants with evolving or established BPD, however, are highly variable between centers. Although this pilot study suggests that NAVA may be successfully used for the management of infants with BPD, sufficient experience and well-designed clinical studies are needed to establish standards of care for defining the role of NAVA in the care of infants with sBPD.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
Keyword
- neurally adjusted ventilatory assist
- severe bronchopulmonary dysplasia
- mechanical ventilation
Publication and Content Type
- ref (subject category)
- art (subject category)
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