{
  "abstract": "Introduction Non-invasive neurally adjusted ventilatory assist (NIV-NAVA) is a ventilation mode that uses the electrical activity of the diaphragm to synchronize respiratory support with the patient's spontaneous effort. It has emerged as a promising non-invasive modality for neonates. We aimed to evaluate the clinical success of NIV-NAVA in a neonatal intensive care unit (NICU) setting. To our knowledge, this is the first study in Portugal to describe the experience with NIV-NAVA in a level III NICU. Methods We conducted an observational retrospective cohort study through a medical record review over four years (January 2021 to December 2024). All newborns admitted to our NICU who were ventilated using NIV-NAVA were included. Descriptive statistical analysis was performed on demographic and diagnostic data. Ventilatory and gasometrical parameters, including fraction of inspired oxygen (FiO₂), pH, and partial pressure of carbon dioxide (pCO₂), were evaluated before and after NIV-NAVA initiation. A respiratory severity score (RSS) was calculated at baseline to assess the severity of respiratory disease. The primary outcome was the proportion of NIV-NAVA episodes not requiring subsequent endotracheal intubation, and success was defined as the avoidance of subsequent intubation. Results A total of 36 NIV-NAVA episodes were recorded across 28 newborns, with a mean gestational age of 26 weeks and a mean birth weight of 822g. All newborns were diagnosed with prematurity, respiratory distress syndrome, and bronchopulmonary dysplasia. The mean baseline RSS was 3.7, reflecting the respiratory disease burden at NIV-NAVA initiation. NIV-NAVA was initiated following extubation in 83.3% of cases and as therapeutic escalation in 16.7%. Success was achieved in 58.3% of all episodes (60% in the post-extubation group and 50% in the escalation group). No statistically significant differences were observed in mean FiO₂ or pCO₂ values before and after NIV-NAVA. Discussion NIV-NAVA success was observed in the majority of newborns, including extremely low birth weight infants with clinically relevant respiratory disease burden. While NIV-NAVA offers significant theoretical advantages regarding patient-ventilator synchronization, published evidence in the NICU remains limited. Conclusion Our findings support the use of NIV-NAVA as a feasible non-invasive ventilatory modality in preterm infants, particularly for post-extubation respiratory support, although further randomized controlled trials are warranted to better establish its role and efficacy within the neonatal population.",
  "abstract_shown": true,
  "affiliations": [
    "Neonatology, São Francisco Xavier Hospital, Western Lisbon Local Health Unit, Lisbon, PRT.",
    "Pediatrics, Cascais Hospital Dr. José de Almeida, Lisbon, PRT."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Madalena Ferreira"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Margarida Roquette"
    },
    {
      "affs": [
        0
      ],
      "name": "Inês Belo"
    },
    {
      "affs": [
        0
      ],
      "name": "Cátia R Correia"
    },
    {
      "affs": [
        0
      ],
      "name": "Anabela Salazar"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/a4rsb0atpc45w.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.116942",
  "fulltext_url": "https://europepmc.org/articles/PMC13696090",
  "id": "a4rsb0atpc45w",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://europepmc.org/article/MED/42928955",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Neonatal Respiratory Health Research"
    ]
  ],
  "openalex": "W7214300678",
  "pdf_url": "https://europepmc.org/articles/PMC13696090?pdf=render",
  "pmcid": "PMC13696090",
  "pmid": "42928955",
  "published": "2026-09-25",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/a4rsb0atpc45w.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:18Z",
      "native_id": "MED:42928955",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42928955"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Neonatal Respiratory Health Research",
      "subfield": "general"
    }
  ],
  "title": "Non-invasive Neurally Adjusted Ventilatory Assist (NIV-Nava): Four-Year Experience in a Level III Neonatal Intensive Care Unit.",
  "title_text": "Non-invasive Neurally Adjusted Ventilatory Assist (NIV-Nava): Four-Year Experience in a Level III Neonatal Intensive Care Unit.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:18Z",
  "url": "https://research.draconitic.com/paper/a4rsb0atpc45w",
  "venue": "Cureus",
  "versions": []
}