Anesthesia Management of a Premature Neonate with Congenital Heart Disease during Emergency Diaphragmatic Hernia Surgery: A Case Report

Authors

  • Fan Zhang Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
  • Zebing Zheng Department of Pediatric and Neonatal Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
  • Taowu Gong Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
  • Zhaoqiong Zhu Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China

DOI:

https://doi.org/10.1532/hsf.4499

Keywords:

congenital heart disease

Abstract

In this medical report, we successfully implemented anesthesia management for an infant with congenital heart disease undergoing congenital diaphragmatic hernia (CDH) repair. Left-sided CDH was diagnosed on a postnatal chest X-ray on day 1 of her life. The child was complicated with congenital heart diseases and pulmonary hypertension and showed severe dyspnea immediately after birth. Thoracoscopic CDH repair puts forward high requirements for anesthesia. Neonatal CDH combined with congenital heart disease brings more challenges to anesthesia. For high-risk premature neonates, anesthesia selections are essential, as those factors directly affect the prognosis. We report the application of S-ketamine as an anesthetic in this kind of operation for the first time. The postoperative recovery was uneventful. This case report reviews anesthesia management of critical CDH neonates, hoping to provide information to healthcare professionals unfamiliar with the treatment of this kind of patient.

References

Aihole JS, Gowdra A, Javaregowda D, Jadhav V, Babu MN, Sahadev R. 2018. A clinical study on congenital diaphragmatic hernia in neonates: our institutional experience. J Indian Assoc Pediatr Surg. 23(3):131-139.

Balasubramanian B, Malde AD, Kulkarni SB. 2019. A non-randomized controlled study of total intravenous anesthesia regimens for magnetic resonance imaging studies in children. J Anaesthesiol Clin Pharmacol. 35(3):379-385.

Choudhry M, Rusu S, Brooks P, Ogundipe E, Chuang SL. 2021. Thoracoscopic repair of congenital diaphragmatic hernia in preterm neonate at 1 kilogram. European J Pediatr Surg Rep. 9:13-16.

Goonasekera C, Ali K, Hickey A, Sasidharan L, Mathew M, Davenport M, et al. 2016. Mortality following congenital diaphragmatic hernia repair: the role of anesthesia. Paediatr Aneaesth. 26(12):1197-1201.

Kays DW. 2017. ECMO in CDH: Is there a role? Seminars in pediatric surgery. 26(3):166–170.

Latham GJ, Yung D. 2019. Current understanding and perioperative management of pediatric pulmonary hypertension. Paediatr Aneaesth. 29(5):441-456.

Pees C, Haas NA, Ewert P, Berger F, Lange PE. 2003. Comparison of analgesic/sedative effect of racemic ketamine and S(+)-ketamine during cardiac catheterization in newborns and children. Pediatr Cardiol. 24(5):424-429.

Qin J, Ren Y, Ma D. 2019. A comparative study of thoracoscopic and open surgery of congenital diaphragmatic hernia in neonates. Journal of Cardiothoracic Surgery. 14(1):118.

Szavay PO, Obermayr F, Maas C, Luenig H, Blumenstock G, Fuchs J. 2012. Perioperative outcome of patients with congenital diaphragmatic hernia undergoing open versus minimally invasive surgery. JLaparoendosc Adv Surg Tech A. 22(03):285-289.

Testini M, Girardi A, Isernia RM, De Palma A, Catalano G, Pezzolla A, et al. 2017. Emergency surgery due to diaphragmatic hernia: case series and review. World J Emerg Surg. 12:23.

Yang MJ, Russell KW, Yoder BA, Fenton SJ. 2021. Congenital diaphragmatic hernia: a narrative review of controversies in neonatal management. Transl Pediatr. 10(5):1432-1447.

Published

2022-04-21

How to Cite

Zhang, F., Zheng, Z., Gong, T., & Zhu, Z. (2022). Anesthesia Management of a Premature Neonate with Congenital Heart Disease during Emergency Diaphragmatic Hernia Surgery: A Case Report. The Heart Surgery Forum, 25(2), E273-E276. https://doi.org/10.1532/hsf.4499

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Article