Neurally adjusted ventilatory assist in neonates with congenital diaphragmatic hernia.

Autor: Kurland Y; Division of Neonatology, Children's Mercy Kansas City, Kansas City, MO, USA. ykurland@cmh.edu., Gurung K; Division of Neonatology, Children's Mercy Kansas City, Kansas City, MO, USA., Pallotto EK; Division of Neonatology, Levine Children's Hospital Atrium Health, Charlotte, NC, USA., Manimtim W; Division of Neonatology, Children's Mercy Kansas City, Kansas City, MO, USA., Feldman K; Health Services and Outcomes Research, Children's Mercy Kansas City; School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA., Staggs VS; Biostatistics and Epidemiology Core, Health Services and Outcomes Research, Children's Mercy Kansas City; School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA., Truog W; Division of Neonatology, Children's Mercy Kansas City, Kansas City, MO, USA.
Jazyk: angličtina
Zdroj: Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2021 Aug; Vol. 41 (8), pp. 1910-1915. Date of Electronic Publication: 2021 Jun 10.
DOI: 10.1038/s41372-021-01098-3
Abstrakt: 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.
(© 2021. The Author(s), under exclusive licence to Springer Nature America, Inc.)
Databáze: MEDLINE
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