Özgün CUVAŞ, Çiğdem ÖZGÜN, Bayazıt DİKMEN, Bilge KARABULUT

Konjenital diafragmatik hernili pediatrik hastada anestezik yaklaşım

Konjenital diafragmatik herni, anestezistler, pediatristler ve çocuk cerrahları için en zorlu vakalardan biri olarak kalmaya devam etmektedir. Konjenital diafragmatik hernili pediatrik hastalarda mevcut olan pulmoner hipoplazi ve pulmoner vasküler problemler , morbidite ve mortalitenin başlıca nedenidir. Ne yazık ki, bu hastalarda sağkalım optimal bakım ile %60-70’dir. Herniye olan organ- arın basısına bağlı olarak gelişen kardiyorespiratuar problemler, eşlik eden sistemik anomaliler (prematürite, kardiyak, solunumsal, renal, gastrointestinal, kromozomal veya santral sinir sistemi ile ilgili), hipoksi, hipovolemi, hipotermi, aspirasyon riski ve peroperatif yoğun bakım ihtiyacı bu hastalarda anestezistlerin üstesinden gelmeleri gereken başlıca sorunlardır. Bu olguda 17 aylık konjenital diafragma hernili bir hastaya anestezik yaklaşımın sunulması amaçlanmıştır.

Anahtar Kelimeler:

Anestezi, Anestezikler, Tomografi, x-ışınlı bilgisayarlı, Süt çocuğu, Fıtık, diyafragmatik, Kadın

Anesthetic management a pediatric patient with congenital diaphragmatic hernia

Congenital diaphragmatic hernia remains one of the most difficult challenges for anaesthetists, pediatricians and pediatric surgeons. Pulmonary hypoplasia and pulmonary vascular problems are the major cause of morbidity and mortality in pediatric patients with congenital diaphragmatic hernia. Unfortunately, the survival remains at 60-70% with optimal care. In these patients, cardiorespiratory distress due to compression of herniated viscera, accompanying systemic abnormalities (prematurity, cardiac, respiratory, renal, gastrointestinal, chromosomal or related to central nervous system), hypoxia, hypovolemia, hypothermia, and risk of aspiration and peroperative need of intensive care are the main problems which the anesthesiologist must deal with. Here we aimed to report our anesthetic management of a 17 month old patient with congenital diaphragmatic hernia.

Keywords:

Anesthesia, Anesthetics, Tomography, X-Ray Computed, Infant, Hernia, Diaphragmatic, Female,

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