Neurally adjusted ventilatory assist in neonates with congenital diaphragmatic hernia.
DOI: 10.1038/s41372-021-01098-3; PMCID: PMC8191439
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.
Journal of perinatology : official journal of the California Perinatal Association
Kurland Y, Gurung K, Pallotto EK, et al. Neurally adjusted ventilatory assist in neonates with congenital diaphragmatic hernia. J Perinatol. 2021;41(8):1910-1915. doi:10.1038/s41372-021-01098-3