Future noninvasive ventilation strategies in neonates

Kimberly S. Firestone, Donald Null, Howard Stein

Research output: Contribution to journalArticle

Abstract

The use of noninvasive ventilation (NIV) has increased over the past decade. Most NICUs use various forms of noninvasive positive pressure ventilation that is influenced by leaks at the interface. This limits the effectiveness of using a flow trigger for synchronous delivery of each breath and the resultant asynchrony contributes to the failure of NIV. Two novel approaches to NIV are now available. Noninvasive neurally adjusted ventilatory assist uses a neural trigger to detect the electrical activation of the diaphragm. Each breath is then proportionally assisted based on the onset, strength, and duration of this electrical signal. It is therefore leak-independent and overcomes the challenges of flow-triggered ventilation. High-frequency nasal ventilation is an extension of bubble continuous positive airway pressure and delivers small tidal volumes at high frequencies that can be adjusted to provide appropriate noninvasive support. The functionality of both these modalities will be discussed, including the clinical evidence available to support their use with NIV.

Original languageEnglish (US)
Pages (from-to)e413-e421
JournalNeoReviews
Volume18
Issue number7
DOIs
StatePublished - Jul 1 2017

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Noninvasive Ventilation
Interactive Ventilatory Support
High-Frequency Ventilation
Continuous Positive Airway Pressure
Positive-Pressure Respiration
Tidal Volume
Diaphragm
Nose
Ventilation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Future noninvasive ventilation strategies in neonates. / Firestone, Kimberly S.; Null, Donald; Stein, Howard.

In: NeoReviews, Vol. 18, No. 7, 01.07.2017, p. e413-e421.

Research output: Contribution to journalArticle

Firestone, Kimberly S. ; Null, Donald ; Stein, Howard. / Future noninvasive ventilation strategies in neonates. In: NeoReviews. 2017 ; Vol. 18, No. 7. pp. e413-e421.
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