Department of Pediatric Cardiology and Cardiac Surgery, Intensive Care Unit, Bambino Gesù Hospital, Rome, Italy.
Pediatr Crit Care Med. 2010 Sep;11(5):e48-51. doi: 10.1097/PCC.0b013e3181dde5ad.
To report the successful application of neurally adjusted ventilatory assist to a child with cystic fibrosis who underwent single-lung transplantation.
Case report.
Pediatric cardiac intensive care unit.
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.
Use of neurally adjusted ventilatory assist to avoid patient-ventilator dyssynchrony and consequent gastric distension.
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.
报告神经调节辅助通气在 1 例接受单肺移植的囊性纤维化患儿中的成功应用。
病例报告。
儿科心脏重症监护病房。
15 岁男性，囊性纤维化，在单肺移植后入住我院儿科心脏重症监护病房。患儿 1 岁时行两次肠切除术，3 岁时行右全肺切除术，10 岁时行经皮内镜胃造口术。移植后，由于感染、气胸和呼吸机不同步导致胃扩张，患儿多次尝试压力支持通气脱机失败，同时出现频繁的恶心和呕吐。
使用神经调节辅助通气以避免人机不同步和胃扩张。
使用神经调节辅助通气可降低过度辅助的风险，预防人机不同步，并成功地使患儿在单肺移植后脱离机械通气。
