The Effect of NIV NAVA 0 on Ventilation in Premature Neonates

Neonates with apnea of prematurity (AOP) deteriorate clinically because CPAP often provides inadequate support during apnea. NAVA provides proportional ventilator support from the electrical activity of the diaphragm. When NAVA level is 0 cmH20/mcV (NN0), patients receive minimal support when breathing and backup ventilation when apneic. This study addresses feasibility of NN0 and time spent in back up ventilation. This was a prospective, two center, observational study of preterm neonates on NN0 for AOP. Ventilator data were downloaded for 24 hours. Number of Clinically Significant Events (CSEs) and switches to back up were collected. Statistics were paired t-test. There were twenty-eight subjects with gestational age of 25 + 1.8 weeks; study age 28 ± 23 days. Number of events were 4±4.39 per 24 hours. Subjects were on NN0 approximately 90% each minute, back-up mode 2.5±1.1 times/minute with 10.6±7.2% in back-up. Conclusion: Preterm neonates on NAVA level 0 had few clinically significant events with minimal time in back up ventilation.