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6-0.65) with PRISm. In a spirometry database at an academic medical center, the PRISm prevalence was 17-24%, which is higher than previously reported. In a spirometry database at an academic medical center, the PRISm prevalence was 17-24%, which is higher than previously reported. The use of neurally-adjusted ventilatory assist (NAVA) during noninvasive ventilation (NIV) results in better patient-ventilator interaction. Whether this improves clinical outcomes lacks dedicated study. In this randomized controlled trial, we compared NAVA