The objective of the Baby Friendly Ventilation Study group is to study different respiratory support modes in order to optimize the given support. The study group operates at the NICU of the Turku University Hospital. The main topics of our research are:
- Control of breathing
- Work of breathing during different respiratory support modes
- The effect of different ventilator modes on infant's physiology
- The effect of different medications on breathing
- The effect of the implementation of NAVA ventilation on different clinical outcomes
The respiratory center in the brainstem controls breathing by sending an impulse to the diaphragm via the phrenic nerve to activate the diaphragm. NAVA ventilation is based on the continuous measurement of this electrical activity with a special nasogastric tube (EAdi catheter) including miniature electrodes. The EAdi signal is amplified, digitalized and filtered and transmitted to the ventilator. The signal is then used as a neural trigger for each breath resulting in better synchrony between the patient and the ventilator. In NAVA ventilation, the patient also controls the respiratory frequency, inspiratory time, inspiratory pressure and the termination of breath.
The Baby Friendly Ventilation Study Group:
Vilhelmiina Parikka, MD, PhD, neonatologist
Arata Oda, MD, neonatologist
Heli Mäntylä, neonatal nurse
Hanna Soukka MD, Docent, neonatologist
Liisa Lehtonen MD, Professor in Pediatrics, neonatologist
Katarzyna Piątek, MD, Research fellow
Soukka H, Parikka V, Lehtonen L. Kokemuksia NAVA-hoidosta Tyksin vastasyntyneiden teho-osastolla. Finnanest 2015; 48(3): 239-241.
Soukka H, Lehtonen L. Clinical Protocol: Neonatal ICU, Neurally Adjusted Ventilatory Assist, NAVA. Critical Care News 2013.
Soukka H, Grönlund L, Leppäsalo J, Lehtonen L. The effects of skin-to-skin care on the diaphragmatic electrical activity in preterm infants. Early Hum Dev 2014; 90(9): 531-534.
Parikka V, Beck J, Zhai Q, Leppäsalo J, Lehtonen L, Soukka H. The Effect of Caffeine Citrate on Neural Breathing Pattern in Preterm Infants. Early Hum Dev 2015; 91: 565-568.
Soukka H, Parikka V, Lehtonen L. NAVA ventilation decreases the need of dexamethasone in extremely preterm infants. Abstract, PAS meeting 2016.
Parikka V, Soukka H, Lehtonen L. The effect of NAVA ventilation on the use of opioids in newborn infants. TAbstract, PAS meeting 2017.
Oda A, Parikka V, Porres I, Lehtonen L, Soukka H. High flow nasal cannulae and nCPAP are effective in decreasing the electrical activity of the diaphragm. Abstract, PAS meeting 2017.
Oda A, Parikka V, Lehtonen L, Porres I, Soukka H. Nasal high flow therapy decreased electrical activity of the diaphragm in preterm infants during the weaning phase. Acta Paediatr 2018: 2018 Jun 30. doi: 10.1111/apa.14485.
Oda A, Parikka V, Lehtonen L, Soukka H. Rapid respiratory transition at birth as evaluated by electrical activity of the diaphragm in very preterm infants supported by nasal CPAP. Respiratory Physiology & Neurobiology 2018, 254: 1-4 https://doi.org/10.1016/j.resp.2018.09.009
Oda A, Lehtonen L, Soukka H. Neurally adjusted respiratory support can be used to wean infants with congenital diaphragmatic hernias off respiratory support. Acta Paediatr 2018; 107(4): 718-9.