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Breathing Effort in Preterm Infants Comparing NIV NAVA and CPAP-A Randomised Crossover Study

Hilde Brenne1, Turid Follestad2, Håkon Bergseng1,3

  • 1Department of Pediatrics, St. Olavs Hospital Trondheim University Hospital, Trondheim, Norway.

Acta Paediatrica (Oslo, Norway : 1992)
|May 10, 2025
PubMed

Insights

Neurally adjusted ventilatory assist (NAVA) significantly reduced breathing effort in preterm infants compared to continuous positive airway pressure (CPAP). This finding suggests NAVA may offer improved respiratory support for vulnerable newborns.

Area of Science:

  • Neonatal Medicine
  • Respiratory Physiology
  • Critical Care

Background:

  • Preterm infants often require respiratory support post-extubation.
  • Neurally adjusted ventilatory assist (NAVA) and continuous positive airway pressure (CPAP) are common non-invasive ventilation strategies.
  • Comparing the efficacy and infant comfort between these methods is crucial for optimizing care.

Purpose of the Study:

  • To compare breathing effort in preterm infants receiving neurally adjusted ventilatory assist (NIV NAVA) versus continuous positive airway pressure (CPAP).
  • To evaluate diaphragmatic load, respiratory parameters, and clinical comfort scores.

Main Methods:

  • A randomized crossover study design was employed.
  • Preterm infants received 4-hour periods of NIV NAVA and CPAP.
  • Breathing effort was quantified using diaphragmatic electrical activity (Edi peak and minimum), respiratory parameters, and comfort scores.

Main Results:

  • A statistically significant reduction in Edi peak was observed with NIV NAVA compared to CPAP.
  • Respiratory rate was significantly lower during NIV NAVA.
  • Clinical distress scores were slightly higher with CPAP, though parental comfort reports were generally positive.

Conclusions:

  • NIV NAVA demonstrates a significant reduction in peak diaphragmatic effort in preterm infants compared to CPAP.
  • These findings suggest potential benefits of NIV NAVA for improving respiratory mechanics and comfort in this population.
Abstract

Keywords:
diaphragmnoninvasive ventilationrespiration

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