OBJECTIVE: To report the successful application of neurally adjusted ventilatory assist to a child with cystic fibrosis who underwent single-lung transplantation. DESIGN: Case report. SETTING: Pediatric cardiac intensive care unit. PATIENT: 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. INTERVENTION: 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.
OBJECTIVE: To report the successful application of neurally adjusted ventilatory assist to a child with cystic fibrosis who underwent single-lung transplantation. DESIGN: Case report. SETTING: Pediatric cardiac intensive care unit. PATIENT: 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. INTERVENTION: 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: Wagner Souza Leite; Alita Novaes; Monique Bandeira; Emanuelle Olympia Ribeiro; Alice Miranda Dos Santos; Pedro Henrique de Moura; Caio César Morais; Catarina Rattes; Maria Karoline Richtrmoc; Juliana Souza; Gustavo Henrique Correia de Lima; Norma Sueli Pinheiro Modolo; Antonio Christian Evangelista Gonçalves; Carlos Alfredo Ramirez Gonzalez; Maria do Amparo Andrade; Armèle Dornelas De Andrade; Daniella Cunha Brandão; Shirley Lima Campos Journal: Multidiscip Respir Med Date: 2020-04-29