The impact of neurally adjusted ventilatory assist mode on respiratory severity score and energy expenditure in infants: a randomized crossover trial.
OBJECTIVE: Examine respiratory severity scores (RSS) (mean airway pressure × fraction of inspired oxygen) and resting energy expenditure (REE) on neurally adjusted ventilatory assist (NAVA) compared with synchronized intermittent mandatory ventilation with pressure controlled and supported breath (SIMV (PC)PS).
STUDY DESIGN: A randomized, crossover trial in a level IV neonatal intensive care unit. Twenty-four patients were ventilated with NAVA or SIMV (PC) PS for 12 h and then crossed over to the alternative mode for 12 h. The primary outcome (RSS) and additional secondary respiratory outcomes were analyzed.
RESULTS: RSS and measured REE were not different between modes. On NAVA, peak inspiratory pressures were lower (17.8 vs 19.9 cmH
CONCLUSION: NAVA mode can be safe without increase in RSS or REE. Although respiratory rates were higher, this was offset by lower peak inspiratory pressures and WOB during NAVA.
Journal of perinatology : official journal of the California Perinatal Association
Cross-Over Studies; Energy Metabolism; Female; Gestational Age; Humans; Infant; Infant, Newborn; Infant, Premature; Intensive Care Units, Neonatal; Interactive Ventilatory Support; Intermittent Positive-Pressure Ventilation; Male; Missouri; Oxygen; Prospective Studies; Respiratory Function Tests; Respiratory Insufficiency; Respiratory Rate; Severity of Illness Index
Energy Metabolism; Neonatal Intensive Care Units; Interactive Ventilatory Support; Intermittent Positive-Pressure Ventilation; Oxygen; Respiratory Function Tests; Respiratory Insufficiency; Respiratory Rate; Severity of Illness Index
Rosterman JL, Pallotto EK, Truog WE, et al. The impact of neurally adjusted ventilatory assist mode on respiratory severity score and energy expenditure in infants: a randomized crossover trial. J Perinatol. 2018;38(1):59-63. doi:10.1038/jp.2017.154