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Anaesthesia in Poland syndrome
R Sethuraman1, S Kannan, I Bala
1Department of Anaesthesia, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Purpose:
To describe the anaesthetic management of a child with Poland syndrome for CT scan.
Clinical Features:
An eight-month-old child presented with left upper limb hypoplasia and chest wall deformity with absence of ribs on the left side for CT scan of thorax. Pulsations of the heart could be seen along with paradoxical respiration over the defect. The trachea was intubated and the lungs ventilated manually to avoid inadequate ventilation and hypoxia.
Conclusions:
The unilateral absence of ribs leads to poor development of subatmospheric pressure in the thorax and paradoxical respiration, and may cause inadequate pulmonary ventilation and hypoxia. In the present case, positive pressure ventilation was chosen to maintain ventilation during the procedure.