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- Title
Asynchrony index during noninvasive neurally adjusted ventilatory assist (NIV NAVA) in pediatrics: a systematic review.
- Authors
Feliciano de Souza, João Marcos; Rebello, Celso Moura; Cardim de Oliveira, Carlos Augusto; Troster, Eduardo Juan
- Abstract
Background: Noninvasive ventilation (NIV) is considered as the first preferred treatment of pediatric acute respiratory failure (ARF). Conventional NIV (CNIV) modes have a higher asynchrony index (AI) when compared to Noninvasive Neurally Adjusted Ventilatory Assist (NIV NAVA) mode. The present study aimed to compare the AI and clinical outcomes during NIV NAVA vs. CNIV in pediatric patients aged between one month and 18 y. Methodology: This is a systematic review of clinical trials conducted between April and May 2020 in the electronic databases, Cochrane Library, Embase, Lilacs, Pubmed/Medline, Scopus and Web of Science. Results: Four out of 184 studies were eligible for qualitative synthesis, presenting 50% "high risk" of bias in the randomization, allocation, and other bias. The sample analyzed 39 participants, aged between 35 days and 15 y, with male predominance (61.5%). The primary outcome analyzed in three out of four studies was the significant decrease (p < 0.001) in the AI during NIV NAVA. Clinical outcomes were inconclusive due to methodological limitations. Conclusion: We conclude that NIV NAVA decreases the AI when compared to CNIV in pediatric patients with ARF. However, the association of the AI reduction and favorable clinical outcomes were inconclusive. Further studies with different methodological formats and larger sample sizes are required to offer definitive conclusions. Registration: The study protocol was registered in PROSPERO: International Prospective Register of Systematic Reviews (ID: 181785).
- Subjects
NONINVASIVE ventilation; TREATMENT effectiveness; ADULT respiratory distress syndrome; PEDIATRIC therapy; CHILD patients
- Publication
Anaesthesia, Pain & Intensive Care, 2021, Vol 25, Issue 5, p575
- ISSN
1607-8322
- Publication type
Article
- DOI
10.35975/apic.v25i5.1622