The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

NEONATES VENTILATED WITH NAVA DO NOT HAVE AN INCREASED INCIDENCE OF IVH, PNEUMOTHORAX OR NEC/PERFORATION COMPARED TO THOSE VENTILATED WITH SIMV/PC WITH PS

Howard Stein, Diane Howard; Toledo Children’s Hospital, Toledo, OH

Background: Neurally Adjusted Ventilatory Assist (NAVA) allows a patient to synchronize spontaneous respiratory effort with mechanical ventilation. Electrodes within a specialized nasogastric tube detect the electrical activity of the diaphragm and transmit this information to the ventilator. The ventilator breath is triggered and terminated by changes in this electrical activity. The patient therefore determines respiratory rate, tidal volumes, peak pressures, inspiratory and expiratory times in total synchrony with the ventilator. We hypothesized that NAVA is as safe as SIMV/PC with PS and that the breath to breath variability in pressures and rate does not increase the incidence of Grade 3 or 4 Intraventricular Hemorrhage (IVH) or pneumothoracies (PTX), or that the specialized nasogastric tube does not increase the risk of Necrotizing Enterocolitis or spontaneous perforation (NEC/perforation) in the smallest, most susceptible premature neonates. Methods: From May 2008 – May 2009 we evaluated all neonates < 1500 grams birth weight or < 31 weeks gestation. Those neonates requiring ventilation were initially ventilated with SIMV/PC with PS and were then placed on NAVA at the discretion of the treating physician. Evaluation for IVH, pneumothorax and NEC/ perforation was done on all neonates on an ongoing basis. Statistics were Chi Squared with Fisher Exact test where appropriate. Results: 29% of neonates < 1500 grams birth weight and 28% of neonates < 31 weeks gestation were ventilated intermittently with NAVA. There were no statistical differences in the incidence of IVH, pneumothorax or NEC/perforation between all neonates and those ventilated on NAVA in either group (Table 1). Conclusion: This is the first study that looks at safety of NAVA in the premature neonate. We conclude that NAVA does not increase the risk of IVH, pneumothoracies or NEC/perf in neonates < 1500 grams birth weight or < 31 weeks gestation compared to SIMV/PC with PS. Sponsored Research - None

Incidence of IVH, pneumothorax and NEC on patients ventilated with NAVA

You are here: RCJournal.com » Past OPEN FORUM Abstracts » 2009 Abstracts » NEONATES VENTILATED WITH NAVA DO NOT HAVE AN INCREASED INCIDENCE OF IVH, PNEUMOTHORAX OR NEC/PERFORATION COMPARED TO THOSE VENTILATED WITH SIMV/PC WITH PS<