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A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
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A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation

Published on: January 17, 2011

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Post-herniorrhaphy extubation technique in pediatric patient with congenital diaphragmatic hernia and VACTERL

Diajeng Putri Iracily1, Desy Rusmawatiningtyas1, Firdian Makrufardi1

  • 1Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia.

Annals of Medicine and Surgery (2012)
|September 20, 2021
PubMed

Insights

Congenital diaphragmatic hernia (CDH) management involves surgical repair and careful extubation. This case highlights a successful positive pressure breath (PPB) extubation technique in a pediatric CDH patient, improving outcomes.

Area of Science:

  • Pediatric Surgery
  • Critical Care Medicine
  • Neonatology

Background:

  • Congenital diaphragmatic hernia (CDH) is a critical condition requiring prompt surgical intervention.
  • Effective postoperative care, including extubation, is vital for reducing morbidity and mortality in CDH patients.
  • This case focuses on a pediatric patient with CDH and VACTERL association.

Observation:

  • A 4-month-old infant presented with respiratory distress due to CDH.
  • The patient underwent laparotomy and herniorrhaphy for definitive treatment.
  • Recurrent left lung atelectasis complicated the extubation process.

Findings:

  • The positive pressure breath (PPB) extubation technique was successfully employed.
  • This technique was chosen over the tracheal suction catheter (TSC) method due to recurrent atelectasis.
  • The patient survived without sequelae and is awaiting stoma closure.

Implications:

  • The PPB technique offers a viable alternative for extubation in complex pediatric CDH cases.
  • This case underscores the importance of tailored extubation strategies in post-herniorrhaphy patients.
  • Further research into optimal extubation methods for CDH patients is warranted.
Abstract

Keywords:
Case reportCongenital diaphragmatic herniaExtubation techniquePediatricVACTERL association

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