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Comparison of extubation success using noninvasive positive pressure ventilation (NIPPV) versus noninvasive neurally adjusted ventilatory assist (NI-NAVA)

Journal of Perinatology volume 40, pages 1202–1210 (2020)Cite this article

Subjects

Abstract

Objective

Compare rates of initial extubation success in preterm infants extubated to NIPPV or NI-NAVA.

Study design

In this pilot study, we randomized 30 mechanically ventilated preterm infants at the time of initial elective extubation to NI-NAVA or NIPPV in a 1:1 assignment. Primary study outcome was initial extubation success.

Results

Rates of continuous extubation for 120 h were 92% in the NI-NAVA group and 69% in the NIPPV group (12/13 vs. 9/13, respectively, p = 0.14). Infants extubated to NI-NAVA remained extubated longer (median 18 vs. 4 days, p = 0.02) and experienced lower peak inspiratory pressures (PIP) than infants managed with NIPPV throughout the first 3 days after extubation. Survival analysis through 14 days post extubation showed a sustained difference in the primary study outcome until 12 days post extubation.

Conclusions

Our study is the first to suggest that a strategy of extubating preterm infants to NI-NAVA may be more successful.

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Acknowledgements

We thank the families for trusting us with the care of their infants enrolled in this trial. We thank the three DSMC members Dr. Jennifer Liedel, Dr. Susan Aucott and Dr. Lily Lou for their inputs during the project to ensure subject safety.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, University of Florida College of Medicine—Jacksonville, Jacksonville, FL, USA

    Kartikeya Makker, Josef Cortez, Kanishk Jha, Sanket Shah, Padma Nandula, David Lowrie & Mark L. Hudak

  2. Center for Health Equity and Research (CHEQR), University of Florida College of Medicine—Jacksonville, Jacksonville, FL, USA

    Carmen Smotherman & Shiva Gautam

Authors
  1. Kartikeya Makker
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  2. Josef Cortez
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  3. Kanishk Jha
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Correspondence to Kartikeya Makker.

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Makker, K., Cortez, J., Jha, K. et al. Comparison of extubation success using noninvasive positive pressure ventilation (NIPPV) versus noninvasive neurally adjusted ventilatory assist (NI-NAVA). J Perinatol 40, 1202–1210 (2020). https://doi.org/10.1038/s41372-019-0578-4

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