Abstract
BACKGROUND: Noninvasive neurally adjusted ventilatory assist (NIV-NAVA) provides synchronized respiratory support based on diaphragmatic electrical activity and has shown efficacy in preterm neonates. However, its efficacy in late preterm and term neonates with transient tachypnea of the newborn (TTN) remains unclear. METHODS: We retrospectively analyzed 183 neonates (≥ 34 weeks' gestation) with TTN between 2016 and 2024 who received initial respiratory support with either NIV-NAVA (n = 68) or sigh positive airway pressure (SiPAP, n = 115). After propensity score matching (PSM), we compared primary outcomes of intubation and treatment failure, the latter defined as a device switch within 6 h. Secondary outcomes included the duration of oxygen therapy. RESULTS: After PSM, 84 neonates (42 per group) were included. The intubation rates did not differ significantly between the SiPAP and NIV-NAVA groups (21.4% vs. 7.1%; p = 0.116). However, treatment failure was significantly lower in the NIV-NAVA group (31.0% vs. 7.1%; p = 0.011) and a shorter duration of oxygen therapy (median, 18 vs. 6 h; p = 0.031). No significant adverse events were observed in either group. CONCLUSION: NIV-NAVA appears to be an effective alternative to SiPAP for managing TTN in late preterm and term neonates. It demonstrated a comparable intubation rate while offering the significant benefits of reducing treatment failure and the duration of oxygen therapy. Further large-scale, prospective studies are warranted to confirm these important findings.