NAVA monitors diaphragmatic electrical activity ($Edi$) to synchronize pressure delivery in preterm infants, virtually eliminating trigger delay and patient-ventilator asynchrony.

Key Physiological Equations & Formulas

• NAVA Level Scaling in Preterms: $$P_{aw} = \text{NAVA level} \times Edi_{peak} + PEEP$$ Provides breath-by-breath proportional support matched to the infant's neural respiratory center.

Practical Clinical Pearls & Bedside Rules

• Non-Invasive NAVA (NIV-NAVA): Delivers synchronized non-invasive breaths via nasal prongs regardless of large mouth or mask leaks.
• Edi as a Monitoring Tool: Baseline $Edi_{min}$ reflects tonic diaphragmatic activity (loss of FRC); $Edi_{peak}$ reflects total neural work of breathing.

Initial Settings & Clinical Titration Protocol

Bedside Troubleshooting & Red Flags

Key Takeaways & Summary

1. Always evaluate patient synchrony and physiological response before changing ventilator parameters.
2. Maintain lung-protective strategies to minimize driving pressure ($\Delta P$) and mechanical power.
3. Continuously reassess liberation and extubation readiness on daily morning rounds.