Can a Diaphragm-Sensing ventilator mode reduce breathing asynchrony?

This trial compares two modes of noninvasive ventilation in adults with acute respiratory failure: standard pressure support (PSV) and a newer mode called Neurally Adjusted Ventilatory Assist (NAVA). NAVA uses electrical signals from the diaphragm to trigger breathing support, which may better match the patient's own breathing efforts. The main goal is to see if NAVA reduces the rate of breathing asynchrony—when the ventilator and the patient are out of sync—compared to PSV. Participants are randomly assigned to receive NAVA first or PSV first, and the study also tracks oxygenation and patient comfort.