Neurally-adjusted ventilation superior to nasal CAP in preventing extubation failure.

Shin SH, Shin SH, Kim SH, Song IG, Jung YH, Kim EK, et al. Noninvasive Neurally Adjusted Ventilation in Postextubation Stabilization of Preterm Infants: A Randomized Controlled Study. J Pediatr. 2022;247:53-9.e1. What is the therapeutic benefit of noninvasive neurally-adjusted ventilatory assist (NIV-NAVA) compared with nasal continuous positive airway pressure (NCPAP), in preventing extubation failure? Randomized controlled trial. Single NICU center in Seoul, Republic of Korea. Infants born at <30 weeks gestation. NIV-NAVA compared with NCPAP. Primary outcome: extubation failure within 72 hours. Extubation failure was higher in the NCPAP group than in the NIV-NAVA group, 28.6% vs 8.6%, P = .031; absolute risk reduction and number needed to treat, 20.0% (95% CI, 2.4%-37.6%) and 5.0 (95% CI, 2.7-41.8), respectively. The two groups demonstrated similar respiratory support duration and severe bronchopulmonary dysplasia incidence. NIV-NAVA more effectively prevented extubation than NCPAP.