Abstract

Manejo anestésico en un recién nacido portador de hernia diafragmática derecha bajo soporte ventilatorio de alta frecuencia oscilatoria.: Reporte de un caso clínico. Anest Analg Reanim [online]. 2013, vol.26, n.1, pp.6-6. ISSN 1688-1273.

SUMMARY  The anesthetic management of diaphragmatic hernia repair in newborns is a challenge that requires to define strategies during pre, intra and postoperative periods. At present, the procedure is postponed until obtaining the best conditions possible, placing special emphasis in preoperative care. Objective: to analyze the anesthetic management using the high-frequency oscillatory ventilation (HFOV) method in the neonatal intensive unit (NICU). We are in the presence of: a newborn with significant respiratory and cardiovascular alterations, a procedure outside the operating room that requires more planning, and a ventilation method that is being used for the first time in the country. The anesthetic technique must comply with the anesthetic objectives. We opted for a total intravenous anesthesia due to the hemodynamic stability, and the impossibility of connecting a humidifier to the ventilator as we would lose the HFOV benefits. It is important to implement a multidisciplinary work, to consider the risk-benefit of performing a procedure in the NICU, to set a team specialized in neonatology, and mainly, to have a specialized area for surgical procedures in neonates in the NICU or near the Unit. We took into account all these elements in this clinical case and yet the mortality rate of this pathology is very high

Keywords : diaphragmatic hernia; newborn; high-frequency ventilation; anesthesia in neonates; anesthesia outside the operating room; fetal circulation; pulmonary hypertension; risk factors.

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