title: Neurally adjusted ventilatory assist and lung transplant in a child: A case report.
abstract: OBJECTIVE
  To report the successful application of neurally adjusted ventilatory assist to a child with cystic fibrosis who underwent single-lung transplantation.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Pediatric cardiac intensive care unit.
  
  
  METHODS
  A 15-yr-old male with cystic fibrosis was admitted to our pediatric cardiac intensive care unit after single-lung transplantation. The child had previously received two bowel resections at the age of 1 yr, right pneumonectomy at the age of 3 yrs, and endoscopic percutaneus gastrostomy at the age of 10 yrs. After transplant, the child failed several attempts of weaning off mechanical ventilation with pressure-support ventilation, due to infection, pneumothorax, and ventilator asynchrony that caused gastric distension and numerous episodes of nausea and vomiting.
  
  
  METHODS
  Use of neurally adjusted ventilatory assist to avoid patient-ventilator dyssynchrony and consequent gastric distension.
  
  
  CONCLUSIONS
  The utilization of neurally adjusted ventilatory assist allowed to limit the risk of overassistance and prevent patient-ventilator asynchrony and to successfully wean the child off mechanical ventilation after single-lung transplant.
authors.affiliation: Department of Pediatric Cardiology and Cardiac Surgery, Intensive Care Unit, Bambino Gesù Hospital, Rome, Italy. ezio.vitale@tin.it
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Vitale
authors.forename: Zaccaria
authors.initials: Z
authors.lastname: Ricci
authors.forename: Stefano
authors.initials: S
authors.lastname: Morelli
authors.forename: Chiara
authors.initials: C
authors.lastname: Giorni
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Testa
authors.forename: Luca
authors.initials: L
authors.lastname: Di Chiara
authors.forename: Giorgio
authors.initials: G
authors.lastname: Conti
authors.forename: Sergio
authors.initials: S
authors.lastname: Picardo
mesh_terms: D000293:Adolescent; D003550:Cystic Fibrosis / Q000628:therapy*; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D012121:Respiration, Artificial; D015300:Ventilator Weaning