Non-invasive respiratory support in preterm infants

Boel, Lieve; Hixson, Thomas; Brown, Lisa M.; Sage, Jayne; Kotecha, Sailesh; Chakraborty, Mallinath

doi:10.1016/j.prrv.2022.04.002

Cited by 6 publications

(6 citation statements)

References 55 publications

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“…One of the main long-term sequelae of preterm birth remains respiratory distress syndrome, which is mainly contributed by the effect of early lung inflammation superimposed on immature lungs ( 83 ).…”

Section: Discussionmentioning

confidence: 99%

Critical review of the evidence for Vojta Therapy: a systematic review and meta-analysis

Sánchez-González,

Sanz-Esteban,

Menéndez-Pardiñas

et al. 2024

Front. Neurol.

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IntroductionIt is essential to link the theoretical framework of any neurophysiotherapy approach with a detailed analysis of the central motor control mechanisms that influence motor behavior. Vojta therapy (VT) falls within interventions aiming to modify neuronal activity. Although it is often mistakenly perceived as exclusively pediatric, its utility spans various functional disorders by acting on central pattern modulation. This study aims to review the existing evidence on the effectiveness of VT across a wide range of conditions, both in the adult population and in pediatrics, and analyze common therapeutic mechanisms, focusing on motor control modulation.AimThe goals of this systematic review are to delineate the existing body of evidence concerning the efficacy of Vojta therapy (VT) in treating a broad range of conditions, as well as understand the common therapeutic mechanisms underlying VT with a specific focus on the neuromodulation of motor control parameters.MethodsPubMed, Cochrane Library, SCOPUS, Web of Science, and Embase databases were searched for eligible studies. The methodological quality of the studies was assessed using the PEDro list and the Risk-Of-Bias Tool to assess the risk of bias in randomized trials. Methodological quality was evaluated using the Risk-Of-Bias Tool for randomized trials. Random-effects meta-analyses with 95% CI were used to quantify the change scores between the VT and control groups. The certainty of our findings (the closeness of the estimated effect to the true effect) was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE).ResultsFifty-five studies were included in the qualitative analysis and 18 in the meta-analysis. Significant differences in cortical activity (p = 0.0001) and muscle activity (p = 0.001) were observed in adults undergoing VT compared to the control, as well as in balance in those living with multiple sclerosis (p < 0.03). Non-significant differences were found in the meta-analysis when evaluating gross motor function, oxygen saturation, respiratory rate, height, and head circumference in pediatrics.ConclusionAlthough current evidence supporting VT is limited in quality, there are indications suggesting its potential usefulness for the treatment of respiratory, neurological, and orthopedic pathology. This systematic review and meta-analysis show the robustness of the neurophysiological mechanisms of VT, and that it could be an effective tool for the treatment of balance in adult neurological pathology. Neuromodulation of motor control areas has been confirmed by research focusing on the neurophysiological mechanisms underlying the therapeutic efficacy of VT.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=476848, CRD42023476848.

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Section: Discussionmentioning

confidence: 99%

Critical review of the evidence for Vojta Therapy: a systematic review and meta-analysis

Sánchez-González,

Sanz-Esteban,

Menéndez-Pardiñas

et al. 2024

Front. Neurol.

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“…Nasal intermittent positive pressure ventilation (NIPPV) is a time-cycled, pressure limited mode of non-invasive ventilation that provides two levels of pressure: a constant positive end expiratory pressure (PEEP) and a higher positive inspiratory pressure (PIP) ( 19 ). Ventilator inflations can be synchronised with the infant's breathing further improving respiratory stability ( 10 ).…”

Section: Non-invasive Respiratory Supportmentioning

confidence: 99%

“…Non-invasive neurally adjusted ventilator assist (NIV-NAVA) uses electrical signals from the diaphragm to trigger breaths and synchronise the ventilatory support with the infant's respiratory efforts ( 19 ). Studies to date have demonstrated its feasibility in preterm infants, but results are limited to short term outcomes ( 30 ).…”

Section: Non-invasive Respiratory Supportmentioning

confidence: 99%

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Neonatal respiratory support strategies—short and long-term respiratory outcomes

Kaltsogianni¹,

Dassios²,

Greenough³

2023

Front. Pediatr.

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Mechanical ventilation (MV), although life-saving, is associated with chronic respiratory morbidity in both preterm and term born infants. New ventilation modes have been developed with the aim of minimising lung injury. These include invasive and non-invasive respiratory support strategies, techniques for less invasive surfactant administration (LISA) and closed-loop automated oxygen control (CLAC) systems. Increasingly, newborn infants with signs of respiratory distress are stabilised on continuous positive airway pressure (CPAP) and receive LISA. Early CPAP when compared to mechanical ventilation reduced the incidence of BPD and respiratory morbidity at 18 to 22 months corrected age. Nasal intermittent positive pressure ventilation reduced treatment failure rates compared to CPAP, but not bronchopulmonary dysplasia (BPD). LISA compared with intubation and surfactant delivery reduced BPD, but there is no evidence from randomised trials regarding long-term respiratory and neurodevelopmental outcomes. Synchronisation of positive pressure inflations with the infant's respiratory efforts used with volume targeting should be applied for infants requiring intubation as this strategy reduces BPD. A large RCT with long term follow up data demonstrated that prophylactic high frequency oscillatory ventilation (HFOV) improved respiratory and functional outcomes at school age, but those effects were not maintained after puberty. CLAC systems appear promising, but their effect on long term clinical outcomes has not yet been explored in randomised trials. Further studies are required to determine the role of newer ventilation modes such as neurally adjusted ventilator assist (NAVA). All such respiratory support strategies should be tested in randomised controlled trials powered to assess long-term outcomes.

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“…The NIV most used in neonatology is Continuous Positive Airway Pressure (CPAP). 8 CPAP has been widely used in Neonatal Intensive Care Units (NICU) as a standard mode of NIV since it was introduced by Gregory et al in 1971. 9 It is necessary to use an interface that connects the circuit to the upper airways of the newborn to provide positive pressure.…”

Section: Introductionmentioning

confidence: 99%

Correlation between nasal anatomical characteristics in newborns and short binasal prong dimensions

Ribeiro,

Nakato,

Hembecker

et al. 2024

Jornal de Pediatria

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Non-invasive respiratory support in preterm infants

Cited by 6 publications

References 55 publications

Critical review of the evidence for Vojta Therapy: a systematic review and meta-analysis

Critical review of the evidence for Vojta Therapy: a systematic review and meta-analysis

Neonatal respiratory support strategies—short and long-term respiratory outcomes

Correlation between nasal anatomical characteristics in newborns and short binasal prong dimensions

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