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Clinics and Practice
Volume 8
Issue 2
10.4081/cp.2018.1057
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Clinics and Practice is published by MDPI from Volume 11 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with PAGEPress.
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Case Report

Anesthetic Management of a Neonate with Congenital Diaphragmatic Hernia under High-Frequency Oscillatory Ventilation

by
Ipek S. Edipoglu
1,*,
Fatma Celik
1,
Tutku Ozdogan
2,
Serdar Comert
2 and
B. Haluk Guvenc
3
1
Department of Anesthesiology, Health Sciences University, Suleymaniye Women Maternity and Child Diseases Training and Research Hospital, Istanbul, Turkey
2
Department of NICU, Health Sciences University, Suleymaniye Women Maternity and Child Diseases Training and Research Hospital, Istanbul, Turkey
3
Department of Pediatric Surgery, Health Sciences University, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
*
Author to whom correspondence should be addressed.
Clin. Pract. 2018, 8(2), 1057; https://doi.org/10.4081/cp.2018.1057
Submission received: 21 December 2017 / Revised: 21 December 2017 / Accepted: 11 April 2018 / Published: 25 June 2018

Abstract

Perioperative management of a neonate with congenital diaphragmatic hernia (CDH) is challenging because of pulmonary hypoplasia, pulmonary hypertension, and respiratory insufficiency. In this report, we present our intra-operative experience in a 4-days old and 3070 grams CDH neonate. He was admitted to neonatal intensive care unit and intubated due to severe respiratory insufficiency. He showed signs of severe pulmonary hypoplasia and his echocardiography revealed a cardiac dextroversion. The patient was relatively stabilized after four days under combined high-frequency oscillatory ventilation (HFOV) and inhaled nitric oxide (iNO). A corrective surgical intervention was sustained with dopamine, dobutamine, fentanyl and midazolam infusions. Ventilator settings were: 9 cmH2O MAP; 15-Hz frequency; 30 cmH2O amplitude and 55% FiO2. Venous-blood gas analysis indicated pH:7.38 pO2:36.2, pCO2:39.2 with SpO2:98%. We believe that HFOV and iNO combination is an effective alternative for the anesthetic management of CDH cases as it provides better gas exchange and less volutrauma.
Keywords: congenital; diaphragmatic; hernia; high-frequency; oscillatory; ventilation congenital; diaphragmatic; hernia; high-frequency; oscillatory; ventilation

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MDPI and ACS Style

Edipoglu, I.S.; Celik, F.; Ozdogan, T.; Comert, S.; Guvenc, B.H. Anesthetic Management of a Neonate with Congenital Diaphragmatic Hernia under High-Frequency Oscillatory Ventilation. Clin. Pract. 2018, 8, 1057. https://doi.org/10.4081/cp.2018.1057

AMA Style

Edipoglu IS, Celik F, Ozdogan T, Comert S, Guvenc BH. Anesthetic Management of a Neonate with Congenital Diaphragmatic Hernia under High-Frequency Oscillatory Ventilation. Clinics and Practice. 2018; 8(2):1057. https://doi.org/10.4081/cp.2018.1057

Chicago/Turabian Style

Edipoglu, Ipek S., Fatma Celik, Tutku Ozdogan, Serdar Comert, and B. Haluk Guvenc. 2018. "Anesthetic Management of a Neonate with Congenital Diaphragmatic Hernia under High-Frequency Oscillatory Ventilation" Clinics and Practice 8, no. 2: 1057. https://doi.org/10.4081/cp.2018.1057

APA Style

Edipoglu, I. S., Celik, F., Ozdogan, T., Comert, S., & Guvenc, B. H. (2018). Anesthetic Management of a Neonate with Congenital Diaphragmatic Hernia under High-Frequency Oscillatory Ventilation. Clinics and Practice, 8(2), 1057. https://doi.org/10.4081/cp.2018.1057

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