General Anesthetic Management of a Child With Horseshoe Lung and Left Lung Hypoplasia for Cheiloplasty: A Case Report

Area of Science:

• Congenital Malformations
• Thoracic Surgery
• Anesthesiology

Background:

• Horseshoe lung is a rare congenital anomaly characterized by fused lungs, potentially leading to reduced lung capacity and functional residual capacity.
• Anesthetic management in patients with horseshoe lung requires careful consideration to prevent hypoxemia and hypercapnia.
• Left lung hypoplasia further complicates respiratory management due to limited pulmonary reserve.

Observation:

• A 3-year-old boy diagnosed with horseshoe lung and left lung hypoplasia was scheduled for cheiloplasty.
• The patient's condition necessitated specific respiratory management strategies during anesthesia.

Findings:

• Anesthetic management focused on preventing intraoperative airway obstruction and maintaining adequate gas exchange.
• Positive end-expiratory pressure was used cautiously to avoid peripheral airway obstruction.
• A prolonged inspiratory phase time was employed to ensure sufficient alveolar expansion.
• Strategies were implemented to maintain gas exchange in the lungs with inherently low reserve capacity.

Implications:

• This case highlights successful anesthetic strategies for managing patients with horseshoe lung and associated respiratory compromise.
• The described respiratory management techniques can serve as a guide for similar rare congenital lung malformations.
• Optimizing respiratory support is crucial for improving outcomes in pediatric patients undergoing surgery with horseshoe lung.