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Abstract
BACKGROUND: We tested whether work of breathing in premature newborns estimated by phase angle (θ) by using respiratory inductance plethysmography is decreased during neurally-adjusted ventilatory assist (NAVA) noninvasive ventilation (NIV) versus NIV alone.
METHODS: NAVA NIV and NIV were applied in random order while using respiratory inductance plethysmography to measure the phase angle.
RESULTS: Patient-ventilator asynchrony was decreased during NAVA NIV; however, the phase angle was not different between the modes. A large number of repeated assists with switches to backup were found when using NAVA NIV. Results of the analysis indicated these were due to the apnea alarm limit set during NAVA NIV.
CONCLUSIONS: The improvement in patient-ventilator synchrony supports the hypothesis that work of breathing may be decreased with NAVA NIV; however, we were unable to demonstrate this with our study design. Short apnea time settings with NAVA NIV led to a large number of switches to backup and repeated assists during the same neural effort. (ClinicalTrials.gov registration NCT02788110.)
- Noninvasive ventilation
- neurally adjusted ventilatory assist
- nasal intermittent positive pressure ventilation
- neonatal respiratory distress syndrome
- bronchopulmonary dysplasia
Footnotes
- Correspondence: David N Matlock MD, University of Arkansas for Medical Sciences, 4301 W. Markham St., Slot 512–5B, Little Rock, AR 72205. E-mail: DMatlock{at}uams.edu
Dr Matlock presented a version of this paper at the Society for Pediatric Research meeting held May 5–8, 2018 in Toronto, Canada.
Drs Beck and Sinderby and Mr Comtois have made inventions related to neural control of mechanical ventilation that are patented. Future commercial uses of this technology may provide financial benefit to Drs Beck and Sinderby through royalties. Drs Beck and Sinderby each own 50% of Neurovent Research Inc. The remaining authors have disclosed no conflicts of interest.
This research was supported by a grant from the Arkansas Children’s Research Institute.
- Copyright © 2020 by Daedalus Enterprises
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