Napolitano N, et al. - In this interventional study, researchers desired to know whether intrinsic positive end-expiratory pressure (PEEP_i), defined as the difference between Pes at start of the inspiratory effort minus Pes at onset of inspiratory flow, was present in infants with severe bronchopulmonary dysplasia (sBPD) during spontaneous breathing and whether adjusting ventilator PEEP improves patient/ventilator synchrony and comfort. Twelve infants have been evaluated for this analysis. Findings suggested that PEEP_i is measurable without the need for pharmacological paralysis in infants with sBPD with concurrent esophageal manometry and flow-time tracings. In those with PEEP_i, synchrony is improved by increasing ventilator PEEP_i to offset PEEP_i. There were no adverse events during the test.