{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:31:35Z","timestamp":1787311895761,"version":"build-2736575974"},"reference-count":42,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respiratory Care"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Neurally Adjusted Ventilatory Assist (NAVA) is a ventilator mode providing improved patient\u2013ventilator synchrony compared to flow- or pressure-triggering. We examined the effect of various NAVA, pressure support (PSV), and PEEP combinations in infants with acute viral bronchiolitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This was a mechanistic study, nested within a randomized controlled feasibility trial. A set of 16 ventilatory combinations (each of 10\u201315 min), including PEEP of 1, 5, and 10 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O; PSV of 20 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O; and NAVA support ranging from 0.5 to 2.0 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O\/\u03bcV, were administered on each of 2 consecutive days to 13 invasively ventilated infants: mean (range) age 4\u2009months (0.1\u201310.0). Outcome measures were grouped according to respiratory drive, respiratory efficiency, expiratory air flow limitation, gas exchange, and tolerability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Higher PEEP levels were associated with better respiratory drive (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001 for electrical activity of the diaphragm and P\n                      <jats:sub>0.1<\/jats:sub>\n                      ), respiratory efficiency (higher tidal volumes and lower breathing frequency, both\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and improved oxygenation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .02). Minute ventilation remained constant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .67), as did transcutaneous CO\n                      <jats:sub>2<\/jats:sub>\n                      (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .60). Expiratory air flow limitation was minimal overall; however, it was reduced on NAVA compared with PSV (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001 for \u03b2 angle). A NAVA support of 0.5 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O\/\u03bcV appeared inadequate for some outcome measures; conversely, the benefit of increasing support beyond 1.0 was modest, and not always apparent across all outcome measures. Altering PEEP did not produce clinically adverse effects on hemodynamics or patient tolerability (COMFORT-B score).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      Higher PEEP values of up to 10 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O may improve respiratory mechanics in acute viral bronchiolitis, without adversely impacting on clinical state. We could not identify an optimal level of NAVA support; however, 0.5 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O\/\u03bcV may be inadequate.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19433654251384560","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T06:17:57Z","timestamp":1761805077000},"page":"263-271","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Interaction of PEEP and Neurally-Adjusted\u00a0Ventilatory Assist in Infants With Acute Viral Bronchiolitis"],"prefix":"10.1177","volume":"71","author":[{"given":"Julia","family":"Harris","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1057-1088","authenticated-orcid":false,"given":"Benjamin","family":"Crulli","sequence":"additional","affiliation":[{"name":"Drs. Harris, Crulli, Nyman, Freire-Gomez, Minen, and Prof. Tibby are affiliated with Pediatric Intensive Care, Evelina London Children\u2019s Hospital, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos M.","family":"Latour","sequence":"additional","affiliation":[{"name":"Drs. Harris and Latour are affiliated with School of Nursing and Midwifery, Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, United Kingdom."},{"name":"Dr. Latour is affiliated with Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, China."},{"name":"Dr. Latour is affiliated with Curtin School of Nursing, Curtin University, Perth, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Nyman","sequence":"additional","affiliation":[{"name":"Drs. Harris, Crulli, Nyman, Freire-Gomez, Minen, and Prof. Tibby are affiliated with Pediatric Intensive Care, Evelina London Children\u2019s Hospital, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xabier","family":"Freire-Gomez","sequence":"additional","affiliation":[{"name":"Drs. Harris, Crulli, Nyman, Freire-Gomez, Minen, and Prof. Tibby are affiliated with Pediatric Intensive Care, Evelina London Children\u2019s Hospital, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Minen","sequence":"additional","affiliation":[{"name":"Drs. Harris, Crulli, Nyman, Freire-Gomez, Minen, and Prof. Tibby are affiliated with Pediatric Intensive Care, Evelina London Children\u2019s Hospital, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7774-8656","authenticated-orcid":false,"given":"Shane M.","family":"Tibby","sequence":"additional","affiliation":[{"name":"Drs. Harris, Crulli, Nyman, Freire-Gomez, Minen, and Prof. Tibby are affiliated with Pediatric Intensive Care, Evelina London Children\u2019s Hospital, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2021.07.009"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2021.5177"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-018-3138-6"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-017-4920-z"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2023-007120"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4377-1984-0.00027-9"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-0496(199703)23:3<176::AID-PPUL2>3.0.CO;2-M"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.162.4.9909004"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10071-23594"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-006-0445-6"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-010-2052-9"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.97.10010177"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/19433654251377666"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11071863"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-1747"},{"key":"e_1_3_3_17_2","unstructured":"Maquet. NAVA study guide. V1.6. 2008. Maquet: Sweden. https:\/\/www.phillipelefevre.com\/downloads\/guidelines\/equipment\/NAVA.pdf"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-018-5045-8"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.10755"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet258"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000002335"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.06510040"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.94.4.799"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.07142"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000446-200501000-00019"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-019-0876-8"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000003147"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.22995"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0286"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-011-2352-8"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2013.08.006"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-5153.2012.00541.x"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-012-2535-y"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23084"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-11-92"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1203\/01.pdr.0000257324.22406.93"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2011.02522.x"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.paed.2017.03.001"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2107143"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200401-042OC"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-020-0638-0"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2012.64"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201511-730ST"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19433654251384560","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19433654251384560","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19433654251384560","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:02:31Z","timestamp":1787310151000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19433654251384560"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,4]]},"references-count":42,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1177\/19433654251384560"],"URL":"https:\/\/doi.org\/10.1177\/19433654251384560","relation":{},"ISSN":["1943-3654","1943-3654"],"issn-type":[{"value":"1943-3654","type":"print"},{"value":"1943-3654","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,4]]}}}