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Research: Neurally adjusted ventilatory assist in neonates with congenital diaphragmatic hernia

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Research: Neurally adjusted ventilatory assist in neonates with congenital diaphragmatic hernia

J Perinatol

. 2021 Jun 10;1-6. doi: 10.1038/s41372-021-01098-3. Online ahead of print . https://pubmed.ncbi.nlm.nih.gov/34112964/

Neurally adjusted ventilatory assist in neonates with congenital diaphragmatic hernia

Yonatan Kurland 1Kamal Gurung 2Eugenia K Pallotto 3Winston Manimtim 2Keith Feldman 4Vincent S Staggs 5William Truog 2Affiliations expand

Free PMC article

Abstract

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.

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