Premature neonates are prone to respiratory distress and need ventilator support because of the rapid breathing and large variations in respiratory patterns. The setting and adjustment of the ventilator for premature neonate is not easy, often resulting in poor patient-ventilator interaction, increased work of breathing, patient discomfort and delayed weaning . Recently, a new ventilation mode (NAVA; Neurally Adjusted Ventilatory Assist) mode, allows the respirator to provide a proportional ventilation mode based on the patients' diaphragm electrical activity, which was validated in many domestic and international clinical researches. The NAVA mode improves patient-ventilator interaction, reduces work of breathing and contributes to early weaning and extubation . When participating in this study, the neonate with receive a special oral tube placement, which is used to replace the original gastric tube to monitor the electrical activity of the diaphragm.
Premature neonates are prone to respiratory distress and need ventilator support because of the rapid breathing and large variations in respiratory patterns. The setting and adjustment of the ventilator for premature neonate is not easy, often resulting in poor patient-ventilator interaction, increased work of breathing, patient discomfort and delayed weaning . Recently, a new ventilation mode (NAVA; Neurally Adjusted Ventilatory Assist) mode, allows the respirator to provide a proportional ventilation mode based on the patients' diaphragm electrical activity, which was validated in many domestic and international clinical researches. The NAVA mode improves patient-ventilator interaction, reduces work of breathing and contributes to early weaning and extubation . When participating in this study, the neonate with receive a special oral tube placement, which is used to replace the original gastric tube to monitor the electrical activity of the diaphragm. The aims of the study are: 1. To select the appropriate ventilation mode and parameters (for example, switch to NIV-NAVA mode); 2. To monitor intermittent apnea, bradycardia and the frequency of cyanosis, 3. To pay attention to the changes in maximum peak pressure, adjust appropriate pressure support, and avoid lung injury. The predicted outcomes of NAVA mode for premature neonate may include : 1. Measurement of the lower PIP value to maintain proper and synchronized ventilation; 2. Monitoring of the diaphragm activity (Edi) signal to evaluate the work of breathing and estimate the weaning time.
Study Type
OBSERVATIONAL
Enrollment
60
NAVA mode during Non-invasive ventilation
Nasal CPAP or NIMV mode during Non-invasive ventilation
Hsin-yu LI
Taipei, Taiwan
Duration of mechanical ventilation
Defined as the time from the start of mechanical ventilation, defined as either the time of in the ICU and until successful weaning mechanical ventilator, with successful weaning defined as ≥5 days of unassisted spontaneous breathing after .
Time frame: Until the date of discharge from ICU, up to 4 weeks
Daily patient physiological blood gas status
Defined as daily PaO2/FiO2 from randomization until successful Weaning.
Time frame: Until the date of discharge from ICU, up to 4 weeks
Length of ICU stay
Defined as the duration of ICU admission from randomization to ICU discharge
Time frame: Until the date of discharge from ICU, up to 4 weeks
Length of hospital stay
Defined as the duration of hospital admission from randomization to hospital discharge
Time frame: Until the date of discharge from ICU, up to 4 weeks
Difference in the number of patient ventilator asynchrony
To assess the difference of number of patient ventilator asynchrony
Time frame: Entire period of ventilatory support, an average of 7 days
Ventilation parameters: peak inspiratory pressure in NIV-NAVA
Evolution of the following parameters: peak inspiratory pressure, tidal volume, PEEP, FiO2, Edi peak, Edi min )
Time frame: Entire period of ventilatory support, an average of 7 days
Ventilation parameters : tidal volume in NIV-NAVA
Evolution of the following parameters: peak inspiratory pressure, tidal volume, PEEP, FiO2, Edi peak, Edi min )
Time frame: through study completion, an average of 7 days
Ventilation parameters : PEEP in NIV-NAVA
Evolution of the following parameters: peak inspiratory pressure, tidal volume, PEEP, FiO2, Edi peak, Edi min )
Time frame: through study completion, an average of 7 days
Ventilation parameters : FiO2 in NIV-NAVA
Evolution of the following parameters: peak inspiratory pressure, tidal volume, PEEP, FiO2, Edi peak, Edi min )
Time frame: through study completion, an average of 7 days
Ventilation parameters : Edi peak in NIV-NAVA
Evolution of the following parameters: peak inspiratory pressure, tidal volume, PEEP, FiO2, Edi peak, Edi min )
Time frame: through study completion, an average of 7 days
Ventilation parameters : Edi min in NIV-NAVA
Evolution of the following parameters: peak inspiratory pressure, tidal volume, PEEP, FiO2, Edi peak, Edi min )
Time frame: through study completion, an average of 7 days
Ventilation parameters : peak inspiratory pressure in NCPA (or NIMV)
Evolution of the following parameters: peak inspiratory pressure, tidal volume, PEEP, FiO2, PC Level, RR)
Time frame: through study completion, an average of 7 days
Ventilation parameters : tidal volume in NCPA(or NIMV)
Evolution of the following parameters: peak inspiratory pressure, tidal volume, PEEP, FiO2, PC, RR)
Time frame: through study completion, an average of 7 days
Ventilation parameters : PEEP in NCPA (or NIMV)
Evolution of the following parameters: peak inspiratory pressure, tidal volume, PEEP, FiO2, PCl, RR)
Time frame: through study completion, an average of 7 days
Ventilation parameters : FiO2 in NCPA or NIMV
Evolution of the following parameters: peak inspiratory pressure, tidal volume, PEEP, FiO2, PC, RR)
Time frame: through study completion, an average of 7 days
Ventilation parameters : pressure control level in NIMV
Evolution of the following parameters: peak inspiratory pressure, tidal volume, PEEP, FiO2, PC, RR)
Time frame: through study completion, an average of 7 days
Ventilation parameters : RR in NIMV
Evolution of the following parameters: peak inspiratory pressure, tidal volume, PEEP, FiO2, PC, RR)
Time frame: through study completion, an average of 7 days
Clinical parameters of Premature: heart rate in NIV-NAVA
Evolution of clinical parameters (heart rate, respiratory rate, blood pressure) at the beginning and end of each period
Time frame: through study completion, an average of 7days
Clinical parameters of Premature: respiratory rate in NIV-NAVA
Evolution of clinical parameters (heart rate, respiratory rate, blood pressure) at the beginning and end of each period
Time frame: through study completion, an average of 7days
Clinical parameters of Premature: SpO2 in NIV-NAVA
Evolution of clinical parameters (SpO2) at the beginning and end of each period
Time frame: through study completion, an average of 7days
Clinical parameters of Premature: blood pressure in NIV-NAVA
Evolution of clinical parameters (heart rate, respiratory rate, blood pressure) at the beginning and end of each period
Time frame: through study completion, an average of 7days
Clinical parameters of Premature: heart rate in NCPA(or NIMV)
Evolution of clinical parameters (heart rate, respiratory rate, blood pressure) at the beginning and end of each period
Time frame: through study completion, an average of 7days
Clinical parameters of Premature: respiratory rate in NCPA (or NIMV)
Evolution of clinical parameters (heart rate, respiratory rate, blood pressure) at the beginning and end of each period
Time frame: through study completion, an average of 7days
Clinical parameters of Premature: blood pressure in NCPA (or NIMV)
Evolution of clinical parameters (heart rate, respiratory rate, blood pressure) at the beginning and end of each period
Time frame: through study completion, an average of 7days
Clinical parameters of Premature: SpO2 in NCPAP(or NIMV)
Evolution of clinical parameters (SpO2) at the beginning and end of each period
Time frame: through study completion, an average of 7days
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.