OBJECTIVE: To analyze the clinical and physiological outcomes of NIV-NAVA in preterm infants compared with other non-invasive respiratory support. STUDY DESIGN: We conducted a meta-analysis of RCTs and randomized crossover studies comparing NIV-NAVA to other non-invasive strategies in preterm neonates. RESULTS: NIV-NAVA was superior to other non-invasive support in maximum EAdi (MD -0.66 microV; 95% CI 1.17 to -0.15; p = 0.01), asynchrony index (MD -49.8%; 95% CI -63.1 to -36.5; p < 0.01), and peak inspiratory pressure (MD -2.2 cmH2O; 95% CI -2.7 to -1.7; p < 0.01). However, there were no significant differences in the incidences of intubation (RR 0.91; 95% CI 0.56 to 1.48; p = 0.71), reintubation (RR 0.72; 95% CI 0.45 to 1.16; p = 0.18), or bronchopulmonary dysplasia (RR 0.77; 95% CI 0.37 to 1.60; p = 0.48). CONCLUSION: NIV-NAVA was associated with improvements in maximum Edi, asynchrony index, and peak inspiratory pressure relative to other non-invasive respiratory strategies, without significant differences in clinical outcomes between groups.
Reprinted by permission from Journal of Perinatology, Macmillan Publishers Ltd.

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