Abstract
Objective:
To study the use of non-invasive ventilation (NIV), and in particular non-invasive neurally adjusted ventilatory assist (NIV-NAVA) in our neonatal intensive care unit (NICU), assessing its feasibility, safety and outcome.
Methods
We conducted a prospective, single-centre observational cohort study, enrolling preterm infants who received at least 24 hours of NIV. Primary endpoints were indication and duration of various NIV modes. Secondary endpoints included significant adverse events such as complications, treatment failure, and the incidence of bronchopulmonary dysplasia (BPD).
Results
Sixty-eight infants were included, with a median gestational age (GA) of 31.3 weeks (IQR 29-32.7) and a median birth weight of 1475 g (IQR 1110-1850). Among them, 36 infants received NIV-NAVA, predominantly as primary support (69.4%). Infants receiving NIV-NAVA had a mean LUS-score at inclusion of 8.6 (SD 2.4, range 3-12) and a median duration of NIV of 32 days (IQR 16.3-65.8). We observed 1 case of pneumothorax and 1 case of pulmonary haemorrhage. The treatment failure rate among infants receiving NIV-NAVA was 22.2%, increasing to 45.5% in extremely premature infants. BPD was diagnosed in 9 (15%) infants.
Conclusion(s)
This study is one of the first prospective trials studying all NIV modes including NIV-NAVA from birth to NICU discharge. Our findings illustrate the feasibility and safety of NIV-NAVA across various ranges of GA, despite higher failure rates in extremely preterm infants. The incidence of BPD among our study population was 15%.