Noninvasive Neurally Adjusted Ventilatory Assist Versus High Flow Cannula Support After Congenital Heart Surgery

Nirbhay Parashar*, Matthew Amidon, Abdulhamid Milad, Adam Devine, Li Yi, Jamie Penk

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Extubation failure rates for critical patients in pediatric intensive care units (ICUs) range from 5% to 29%. Noninvasive (NIV) ventilation has been shown to decrease extubation failure. We compared reintubation rates and outcomes of patients supported with NIV neurally adjusted ventilation assist (NAVA) versus historical controls supported with high-flow nasal cannula (HFNC). Methods: Case–control study of infants less than three months of age who underwent cardiac surgery and received NIV support after extubation from January 2011 to May 2017. All patients supported with NIV NAVA after it became available in September 2013 were compared to matched patients extubated to HFNC from prior to September 2013. Results: Forty-two patients identified for the NIV NAVA group were matched with 42 historical controls supported with HFNC. Groups had similar baseline characteristics based on rate of acute kidney injury, number of single ventricle patients, Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) category, age, weight, bypass time, and duration of intubation. There was no significant difference in reintubation rates within 72 hours (14.3% in the HFNC group and 16.7% in the NIV NAVA group, P = 1.0). Median duration from extubation to coming off NIV support was longer in the NIV NAVA group (3.6 days vs 0.6 days, P <.001). Median time from extubation to ICU discharge was longer in the NIV NAVA group (10.5 vs 6.8 days, P =.02), as was total postoperative ICU length of stay (LOS; 17.6 vs 12.2, P =.01). Conclusions: Introduction of NIV NAVA for postextubation support did not reduce reintubation rates compared to HFNC. Further study is needed as adoption of NIV NAVA may prolong LOS.

Original languageEnglish (US)
Pages (from-to)565-571
Number of pages7
JournalWorld Journal for Pediatric and Congenital Heart Surgery
Issue number5
StatePublished - Sep 1 2019


  • congenital heart surgery
  • intensive care
  • morbidity)
  • outcomes (includes mortality
  • pediatric
  • postoperative care
  • reintubation
  • ventilation

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Noninvasive Neurally Adjusted Ventilatory Assist Versus High Flow Cannula Support After Congenital Heart Surgery'. Together they form a unique fingerprint.

Cite this