{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T14:42:08Z","timestamp":1776436928897,"version":"3.51.2"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:00:00Z","timestamp":1738108800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:00:00Z","timestamp":1738108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>To assess respiratory changes after neurally adjusted ventilatory assist (NAVA) initiation in preterm infants with evolving or established bronchopulmonary dysplasia (BPD). Premature infants born less than 32\u00a0weeks gestation with evolving or established BPD initiated on invasive or non-invasive (NIV) NAVA were included. Respiratory data: PCO<jats:sub>\u2082<\/jats:sub> and SpO\u2082\/FiO\u2082 (S\/F) ratio before and at 4, 24, 48\u00a0h post-NAVA initiation were collected. Eighty-eight infants, median GA 25.1 (range 22.7\u201330.3) weeks, with 191 NAVA episodes were included. Infants born\u2009&lt;\u200932\u00a0weeks with evolving and established BPD showed improvements in PCO<jats:sub>\u2082<\/jats:sub> and S\/F ratio 48\u00a0h post-NAVA compared to prior: 7.6 (4.5\u201311.8) versus 8.1 (4.7\u201313.1) kPa; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 and 285 (118\u2013471) versus 276 (103\u2013471); <jats:italic>p<\/jats:italic>\u2009=\u20090.013, respectively. Improvements were observed in invasive NAVA: 7.6 (4.5\u201311.8) versus 8.5 (4.7\u201312.4) kPa; <jats:italic>p<\/jats:italic>\u2009=\u20090.001, 290 (148\u2013471) versus 271 (103\u2013467); <jats:italic>p<\/jats:italic>\u2009=\u20090.002, and NIV-NAVA: 7.5 (4.6\u201311.7) versus 7.9 (5.2\u201313.1) kPa; <jats:italic>p<\/jats:italic>\u2009=\u20090.001, 283 (128\u2013471) versus 294 (114\u2013471); <jats:italic>p<\/jats:italic>\u2009=\u20090.002. Severe BPD infants had reductions in PCO<jats:sub>\u2082<\/jats:sub> 48\u00a0h post-initiation: 7.2 (5.6\u20139.7) versus 8.0 (5.4\u201311.7) kPa; <jats:italic>p<\/jats:italic>\u2009=\u20090.002, with lower FiO\u2082 requirements 0.37 (0.21\u20130.65) versus 0.43 (0.21\u20130.8); <jats:italic>p<\/jats:italic>\u2009=\u20090.011, and improved S\/F ratios 263 (146\u2013471) versus 219 (114\u2013457); <jats:italic>p<\/jats:italic>\u2009=\u20090.006. On subgroup analysis, similar improvements were noted in; PCO<jats:sub>2<\/jats:sub> levels in invasive NAVA (<jats:italic>p<\/jats:italic>\u2009=\u20090.011) and NIV-NAVA (<jats:italic>p<\/jats:italic>\u2009=\u20090.002), S\/F ratios in invasive NAVA (<jats:italic>p<\/jats:italic>\u2009=\u20090.046) and NIV-NAVA (<jats:italic>p<\/jats:italic>\u2009=\u20090.002) and FiO\u2082 in invasive NAVA (<jats:italic>p<\/jats:italic>\u2009=\u20090.034) and NIV-NAVA (<jats:italic>p<\/jats:italic>\u2009=\u20090.053).<\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusion<\/jats:italic>: NAVA improves CO<jats:sub>\u2082<\/jats:sub> clearance and oxygenation in infants with evolving or established and severe BPD at 48\u00a0h post-initiation. In severe BPD, NAVA also reduced oxygen requirements\n<jats:table-wrap>\n              <jats:table>\n                <jats:tbody>\n                  <jats:tr>\n                    <jats:td colspan=\"2\">\n                      <jats:bold>What is Known:<\/jats:bold> \u2022 <jats:italic>NAVA has the potential to improve CO<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>2<\/jats:italic>\n                      <\/jats:sub>\n                      <jats:italic>clearance and oxygenation by optimising alveolar ventilation, adapting to the infant's breathing patterns, and enhancing gas exchange.<\/jats:italic>\n                    <\/jats:td>\n                  <\/jats:tr>\n                  <jats:tr>\n                    <jats:td colspan=\"2\">\n                      <jats:bold>What is New:<\/jats:bold> \u2022 <jats:italic>The beneficial effects of NAVA are sustained in infants with evolving or established bronchopulmonary dysplasia (BPD), improving carbon dioxide clearance and oxygenation at 48 hours after initiation.<\/jats:italic>\n                    <\/jats:td>\n                  <\/jats:tr>\n                <\/jats:tbody>\n              <\/jats:table>\n            <\/jats:table-wrap>\n          <\/jats:p>","DOI":"10.1007\/s00431-025-05997-x","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T06:30:53Z","timestamp":1738132253000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Respiratory physiological changes post initiation of neurally adjusted ventilatory assist in preterm infants with evolving or established bronchopulmonary dysplasia"],"prefix":"10.1007","volume":"184","author":[{"given":"Basma","family":"Mohamed","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anay","family":"Kulkarni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donovan","family":"Duffy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Greenough","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandeep","family":"Shetty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,29]]},"reference":[{"key":"5997_CR1","doi-asserted-by":"publisher","first-page":"e7976","DOI":"10.1136\/bmj.e7976","volume":"345","author":"KL Costeloe","year":"2012","unstructured":"Costeloe KL, Hennessy EM, Haider S, Stacey F, Marlow N, Draper ES (2012) Short term outcomes after extreme preterm birth in England: comparison of two birth cohorts in 1995 and 2006 (the EPICure studies). 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