• Vincenzo Vitale, Zaccaria Ricci, Stefano Morelli, Chiara Giorni, Giuseppina Testa, Luca Di Chiara, Giorgio Conti, and Sergio Picardo.
• Department of Pediatric Cardiology and Cardiac Surgery, Intensive Care Unit, Bambino Gesù Hospital, Rome, Italy. ezio.vitale@tin.it
• Pediatr Crit Care Me. 2010 Sep 1; 11 (5): e48-51.

ObjectiveTo report the successful application of neurally adjusted ventilatory assist to a child with cystic fibrosis who underwent single-lung transplantation.DesignCase report.SettingPediatric cardiac intensive care unit.PatientA 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.InterventionUse of neurally adjusted ventilatory assist to avoid patient-ventilator dyssynchrony and consequent gastric distension.ConclusionsThe 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.

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