In this physiological study, we report an improvement of respiratory unloading by adding a second level of pressure with NAVA in infants with severe bronchiolitis. WOB decreased immediately after switching to NAVA, as reported previously in adults with obstructive lung diseases, and was associated with a lower neural drive and Ti/Ttot ratio. This study has several limitations, including the small sample size, the short study period, the non-randomized order of recordings, and the non-standardized NAVA settings. However, the consistent, rapid, and large improvement in WOB-related indices observed in every infant is an important finding, especially considering the number of infants with severe bronchiolitis who may benefit from an improvement in non-invasive support. The findings support the need for further evaluation of the potential interest of NAVA to improve the efficiency of non-invasive support in infants with bronchiolitis.

Read More