ArticlePediatric pulmonology2026
A physiologic Comparison of Continuous Neurally Adjusted Ventilation (NeuroPAP) Versus Neurally-Adjusted Ventilatory Assist (NAVA) in Infants With Respiratory Failure.
Article in Pediatric pulmonology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Triggering modalities to synchronise non-invasive respiratory support in preterm infants: a systematic review and meta-analysis.BMJ paediatrics open · 2026Pooled it
- A physiologic Comparison of Continuous Neurally Adjusted Ventilation (NeuroPAP) Versus Neurally-Adjusted Ventilatory Assist (NAVA) in Infants With Respiratory Failure.Pediatric pulmonology · 2026Article
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Authors and funding
9 authors.
Funding
Abstract
objectives and hypothesisTonic diaphragmatic activity is common during non-invasive ventilation (NIV), suggesting efforts to increase end-expiratory lung volume. We assessed the feasibility and physiological impact of NeuroPAP, a novel NIV mode continuously adjusting the delivered positive pressure proportionally to diaphragm electric activity (Edi) during both inspiration and expiration, in infants with respiratory failure. We hypothesized NeuroPAP would enable dynamic control of end-expiratory pressures (PEEP). METHODOLOGY: This prospective crossover study enrolled premature neonates (25-34 weeks) and infants with bronchiolitis supported by NIV-NAVA. Subjects underwent three ventilation phases: NIV-NAVA, NeuroPAP, and repeat NIV-NAVA. Ventilation pressures, Edi, cardio-respiratory events, neural breathing patterns, and systemic and cerebral oxygenation were assessed.
resultsA total of 15 infants with bronchiolitis and 8 premature neonates were included. The overall median PEEP was unchanged between modes, but PEEP was actively adjusted, with increased breath-to-breath variability of PEEP in NeuroPAP (p < 0.001). Compared to pre-study settings, individual PEEP increased in NeuroPAP in 7, decreased in 9, and was unchanged in 7 patients. In NeuroPAP, the breathing pattern was phasic 74% of the time and tonic 16% of the time, compared to 61% (p = 0.31) and 23% (p = 0.36) in NIV-NAVA. Respiratory rate was lower in NeuroPAP in the neonates (p = 0.006). The estimated PaO
conclusionIn infants with respiratory failure, NeuroPAP allowed dynamic control and personalization of PEEP. The clinical impact of this warrants further evaluation.
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