Optimizing Invasive Neonatal Respiratory Care: A Systematic Review of Invasive Neurally Adjusted Ventilatory Assist
Background: Mechanical ventilation in preterm neonates aims for synchrony, preventing complications such as lung injury. Neurally Adjusted Ventilatory Assist (NAVA) is a unique mode relying on diaphragmatic electrical signals for synchronization. We conducted a review focusing on the long-term conse...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/12/6/632 |
| _version_ | 1797240822587981824 |
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| author | Palanikumar Balasundaram Mohamed Sakr |
| author_facet | Palanikumar Balasundaram Mohamed Sakr |
| author_sort | Palanikumar Balasundaram |
| collection | DOAJ |
| description | Background: Mechanical ventilation in preterm neonates aims for synchrony, preventing complications such as lung injury. Neurally Adjusted Ventilatory Assist (NAVA) is a unique mode relying on diaphragmatic electrical signals for synchronization. We conducted a review focusing on the long-term consequences of using invasive NAVA in neonates with a focus on bronchopulmonary dysplasia (BPD). Methods: A systematic review following PRISMA explored invasive NAVA in preterm neonates. Primary objectives compared NAVA to conventional ventilation, assessing BPD incidence, ventilation duration, length of stay, and adverse events. Secondary objectives analyzed ventilator parameters. Results: After screening 282 records, the review incorporated two randomized controlled trials for primary outcomes and seven trials for secondary outcomes, including two randomized crossovers, four prospective crossovers, and one retrospective study. NAVA showed reduced oxygen requirement at 28 days but no significant differences in oxygen need at 36 weeks postmenstrual age, total length of stay, or ventilator days. Substantial variations were not observed in adverse events. Ventilator variables favored NAVA, indicating decreased peak inspiratory pressure, tidal volume, work of breathing, and respiratory severity score. Conclusion: Our study found no significant reduction in BPD with NAVA despite short-term benefits. Future large-scale trials are essential to assess NAVA’s impact on long-term outcomes comprehensively. |
| first_indexed | 2024-04-24T18:13:32Z |
| format | Article |
| id | doaj.art-7760ccf1bab54854baa4d3041ed331f1 |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-04-24T18:13:32Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-7760ccf1bab54854baa4d3041ed331f12024-03-27T13:43:40ZengMDPI AGHealthcare2227-90322024-03-0112663210.3390/healthcare12060632Optimizing Invasive Neonatal Respiratory Care: A Systematic Review of Invasive Neurally Adjusted Ventilatory AssistPalanikumar Balasundaram0Mohamed Sakr1Division of Neonatology, Department of Pediatrics, Mercy Health—Javon Bea Hospital, Rockford, IL 61114, USADivision of Neonatology, The Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY 10461, USABackground: Mechanical ventilation in preterm neonates aims for synchrony, preventing complications such as lung injury. Neurally Adjusted Ventilatory Assist (NAVA) is a unique mode relying on diaphragmatic electrical signals for synchronization. We conducted a review focusing on the long-term consequences of using invasive NAVA in neonates with a focus on bronchopulmonary dysplasia (BPD). Methods: A systematic review following PRISMA explored invasive NAVA in preterm neonates. Primary objectives compared NAVA to conventional ventilation, assessing BPD incidence, ventilation duration, length of stay, and adverse events. Secondary objectives analyzed ventilator parameters. Results: After screening 282 records, the review incorporated two randomized controlled trials for primary outcomes and seven trials for secondary outcomes, including two randomized crossovers, four prospective crossovers, and one retrospective study. NAVA showed reduced oxygen requirement at 28 days but no significant differences in oxygen need at 36 weeks postmenstrual age, total length of stay, or ventilator days. Substantial variations were not observed in adverse events. Ventilator variables favored NAVA, indicating decreased peak inspiratory pressure, tidal volume, work of breathing, and respiratory severity score. Conclusion: Our study found no significant reduction in BPD with NAVA despite short-term benefits. Future large-scale trials are essential to assess NAVA’s impact on long-term outcomes comprehensively.https://www.mdpi.com/2227-9032/12/6/632neurally adjusted ventilatory assistbronchopulmonary dysplasiapretermpatient–ventilator synchrony |
| spellingShingle | Palanikumar Balasundaram Mohamed Sakr Optimizing Invasive Neonatal Respiratory Care: A Systematic Review of Invasive Neurally Adjusted Ventilatory Assist Healthcare neurally adjusted ventilatory assist bronchopulmonary dysplasia preterm patient–ventilator synchrony |
| title | Optimizing Invasive Neonatal Respiratory Care: A Systematic Review of Invasive Neurally Adjusted Ventilatory Assist |
| title_full | Optimizing Invasive Neonatal Respiratory Care: A Systematic Review of Invasive Neurally Adjusted Ventilatory Assist |
| title_fullStr | Optimizing Invasive Neonatal Respiratory Care: A Systematic Review of Invasive Neurally Adjusted Ventilatory Assist |
| title_full_unstemmed | Optimizing Invasive Neonatal Respiratory Care: A Systematic Review of Invasive Neurally Adjusted Ventilatory Assist |
| title_short | Optimizing Invasive Neonatal Respiratory Care: A Systematic Review of Invasive Neurally Adjusted Ventilatory Assist |
| title_sort | optimizing invasive neonatal respiratory care a systematic review of invasive neurally adjusted ventilatory assist |
| topic | neurally adjusted ventilatory assist bronchopulmonary dysplasia preterm patient–ventilator synchrony |
| url | https://www.mdpi.com/2227-9032/12/6/632 |
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