• David N Matlock, Shasha Bai, Michael D Weisner, Norman Comtois, Jennifer Beck, Christer Sinderby, and Sherry E Courtney.
• Department of Pediatrics, Neonatology Division, University of Arkansas for Medical Sciences, Little Rock, Arkansas. DMatlock@uams.edu.
• Respir Care. 2020 Jul 1; 65 (7): 946-953.

BackgroundWe tested whether work of breathing in premature newborns estimated by phase angle (θ) by using respiratory inductance plethysmography is decreased during neurally-adjusted ventilatory assist (NAVA) noninvasive ventilation (NIV) versus NIV alone.MethodsNAVA NIV and NIV were applied in random order while using respiratory inductance plethysmography to measure the phase angle.ResultsPatient-ventilator asynchrony was decreased during NAVA NIV; however, the phase angle was not different between the modes. A large number of repeated assists with switches to backup were found when using NAVA NIV. Results of the analysis indicated these were due to the apnea alarm limit set during NAVA NIV.ConclusionsThe improvement in patient-ventilator synchrony supports the hypothesis that work of breathing may be decreased with NAVA NIV; however, we were unable to demonstrate this with our study design. Short apnea time settings with NAVA NIV led to a large number of switches to backup and repeated assists during the same neural effort. (ClinicalTrials.gov registration NCT02788110.).Copyright © 2020 by Daedalus Enterprises.

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