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The following is a summary of “Comparison of neurally adjusted ventilatory assist and synchronized intermittent mandatory ventilation in preterm infants after patent ductus arteriosus ligation: a retrospective study,” published in the April 2024 issue of Pediatrics by Lin et al.

This study sought to investigate the comparative effectiveness of neurally adjusted ventilatory assist (NAVA) versus synchronized intermittent mandatory ventilation (SIMV) in mechanically ventilated preterm infants following patent ductus arteriosus (PDA) ligation.

In this retrospective analysis, a cohort of intubated preterm infants who underwent PDA ligation at the institution between July 2021 and January 2023 was examined. These infants were stratified into two groups based on the post-surgery ventilation mode: NAVA or SIMV.

The analysis encompassed 50 preterm infants, revealing notable differences between the NAVA and SIMV groups. Specifically, during treatment, the NAVA group exhibited lower peak inspiratory pressure (PIP) and mean airway pressure (MAP) compared to the SIMV group (PIP: 19.1 ± 2.9 vs. 22.4 ± 3.6 cmH₂O, P < 0.001; MAP: 9.1 ± 1.8 vs. 10.9 ± 2.7 cmH₂O, P = 0.002). Additionally, parameters indicative of oxygenation, such as PaO₂ and PaO₂/FiO₂ ratio, were notably improved in the NAVA group (PaO₂: 94.0 ± 11.7 vs. 84.8 ± 15.8 mmHg, P = 0.031; PaO₂/FiO₂: 267 [220–322] vs. 232 [186–290] mmHg, P = 0.025). Furthermore, the need for sedation was significantly reduced in the NAVA group compared to SIMV (midazolam: 1.5 ± 0.5 vs. 1.1 ± 0.3 μg/kg/min, P < 0.001).

In conclusion, the early implementation of NAVA following PDA ligation in preterm infants was associated with favorable outcomes, including decreased ventilator pressures, reduced sedation requirements, and improved oxygenation parameters compared to SIMV. Nevertheless, further prospective studies are warranted to comprehensively evaluate the clinical benefits of NAVA ventilation in this patient population.

Source: bmcpediatr.biomedcentral.com/articles/10.1186/s12887-024-04727-w