Neurally adjusted ventilatory assist and lung transplant in a child: A case report.
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.
Vitale
Vincenzo
V
Department of Pediatric Cardiology and Cardiac Surgery, Intensive Care Unit, Bambino Gesù Hospital, Rome, Italy. ezio.vitale@tin.it
Ricci
Zaccaria
Z
Morelli
Stefano
S
Giorni
Chiara
C
Testa
Giuseppina
G
Di Chiara
Luca
L
Conti
Giorgio
G
Picardo
Sergio
S
D000293:Adolescent; D003550:Cystic Fibrosis / Q000628:therapy*; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D012121:Respiration, Artificial; D015300:Ventilator Weaning