{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T23:21:29Z","timestamp":1788391289368,"version":"build-2803163510"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":55,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AJP Rep"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background Pneumatoceles are air-filled cystic lesions within the lung parenchyma, often arising from severe pneumonia or mechanical ventilation-induced lung injury, which pose significant risk, particularly in neonates requiring high positive-pressure ventilation. Traditional management includes conservative monitoring, percutaneous drainage, and\/or surgical intervention. High-frequency ventilation is frequently employed to minimize barotrauma.<\/jats:p>\n                  <jats:p>Case Summary We present a neonate born at 290\/7 weeks of gestation, weighing 780 g. Post-delivery, the patient developed pneumonia, leading to multiple refractory bilateral pneumatoceles and transfer to our hospital. Initial management included high-frequency jet ventilation and inhaled nitric oxide, with limited improvement over 3 weeks, after which we initiated neurally adjusted ventilatory assist (NAVA), leading to significant clinical improvement. Radiographic imaging showed rapid improvement of the pneumatoceles on NAVA, with complete resolution observed at outpatient follow-up.<\/jats:p>\n                  <jats:p>Discussion This case demonstrates successful management of refractory bilateral pneumatoceles using NAVA. Its patient-driven approach provides synchronized, gentle ventilation, crucial for treating pulmonary air leak syndromes and facilitating natural weaning. NAVA\u2019s dynamic adjustments and ability to closely match ventilatory support to the patient\u2019s neural respiratory drive using less peak inspiratory pressure offers a promising strategy for managing complex pulmonary conditions, such as pneumatoceles, in neonates.<\/jats:p>","DOI":"10.1055\/a-2945-0611","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T23:01:46Z","timestamp":1787698906000},"page":"e154-e158","source":"Crossref","is-referenced-by-count":0,"title":["Successful Use of Neurally Adjusted Ventilatory Assist in Managing Refractory Bilateral Pneumatoceles in a Premature Neonate"],"prefix":"10.1055","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1718-6345","authenticated-orcid":false,"given":"Efren","family":"Diaz","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center, Texas, United States","place":["Dallas"],"department":["Department of Pediatrics, Division of Neonatal-Perinatal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamaila","family":"Gil","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center, Texas, United States","place":["Dallas"],"department":["Department of Pediatrics, Division of Neonatal-Perinatal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5656-2762","authenticated-orcid":false,"given":"Lisa M.","family":"Scheid","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center, Texas, United States","place":["Dallas"],"department":["Department of Pediatrics, Division of Neonatal-Perinatal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"issue":"10","key":"ref1","doi-asserted-by":"crossref","first-page":"2532","DOI":"10.1002\/ppul.24969","article-title":"Pulmonary pneumatoceles in neonates","volume":"55","author":"G Rocha","year":"2020","journal-title":"Pediatr Pulmonol"},{"issue":"08","key":"ref2","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1055\/s-0032-1331028","article-title":"Pneumatoceles in infants in the neonatal intensive care unit: clinical characteristics and outcomes","volume":"30","author":"P Arora","year":"2013","journal-title":"Am J Perinatol"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1038\/jp.2009.162","article-title":"Pneumatoceles in preterm infants-incidence and outcome in the post-surfactant era","volume":"30","author":"N Hussain","year":"2010","journal-title":"J Perinatol"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"E69","DOI":"10.1002\/ppul.22831","article-title":"Disseminated, large-sized neonatal pneumatoceles: the wait-and-see strategy","volume":"49","author":"E Maranella","year":"2014","journal-title":"Pediatr Pulmonol"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1089\/lap.2007.0137","article-title":"Thoracoscopic treatment of a neonatal traumatic pneumatocele","volume":"18","author":"C C Jackson","year":"2008","journal-title":"J Laparoendosc Adv Surg Tech A"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1097\/00005373-200005000-00027","article-title":"Acinetobacter calcoaceticus pneumonia and the formation of pneumatoceles","volume":"48","author":"J P Hunt","year":"2000","journal-title":"J Trauma"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.jiac.2022.12.015","article-title":"Multiple pneumatoceles and lung abscesses caused by early-onset E. 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