775 GRAM PREMATÜRE HASTADA PDA KAPATILMASI SIRASINDAKİ ANESTEZİ YÖNETİMİMİZ-OLGU SUNUMU ANESTHESIA MANAGEMENT OF 775 GRAMS PREMATURE PATIENT DURING PDA LIGATION-A CASE REPORT
| Autor: | Sengül Özmert, Mine Akin, Sibel Saydam, Ugursay Kiziltepe, Feyza Sever, Yesim Senayli, Gülsen Keskin |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Bradycardia
medicine.medical_specialty Respiratory distress business.industry medicine.medical_treatment lcsh:R Hasta lcsh:Medicine Intensive care unit Surgery law.invention medicine.anatomical_structure Health Care Sciences and Services law Anesthesia Ductus arteriosus Anesthetic medicine Ketamine Thoracotomy Anahtar Kelimeler: Patent duktus arteriozus çok düşük doğum ağırlığı prematüre pediyatrik anestezi Sağlık Bilimleri ve Hizmetleri medicine.symptom business medicine.drug |
| Zdroj: | Çağdaş Tıp Dergisi, Vol 6, Iss 1, Pp 47-50 (2015) Volume: 6, Issue: 1 47-50 Çağdaş Tıp Dergisi |
| ISSN: | 2146-6009 |
| Popis: | OZET Belirgin soldan saga santa neden olan patent duktus arteriozus (PDA), cok dusuk dogum agirlikli (CDDA) premature bebeklerde onemli mortalite ve morbidite nedenidir. Tibbi tedavi ile kapanmayan PDA vakalarina cerrahi ligasyon teknigi uygulanir. Literaturde, bu vakalarin ameliyathanede mi yoksa yenidogan yogun bakim unitesinde mi alinacagi, ideal anestezi yonetiminin ne olacagi konusunda fikir birligi yoktur. CDDA premature, ciddi kardiak, pulmoner ve renal yetmezligi olan olgumuza cerrahi ligasyon sirasinda uyguladigimiz anestezi yonetimimizi tartismayi planladik. 775 gr agirliginda respiratuar distres sendromu, ciddi pnomonisi ve bobrek yetmezligi olan, 8 gunluk premature kiz hastaya PDA ligasyonunun ameliyathane kosullarinda yapilmasi planlandi. Anestezi induksiyonu ve idamesinde ketamin kullanilirken, kas gevsetici ve inhalasyon ajani ihtiyaci olmadi. Peroperatif donemde sekresyon artisi, desaturasyon ve bradikardi goruldu. Adrenalin iv ile kan basinci ve kalp atim hizi duzelen hasta operasyon sonrasi yenidogan yogun bakim unitesine transfer edildi. Coklu organ yetmezligi olan, premature, CDDA vakalarda, yenidogan yogun bakim unitesinin kosullarinin uygun olmadigi durumlarda ameliyathaneye guvenli transport saglanarak, acik kuvozde, ketamin anestezisi ile PDA ligasyonunun guvenle yapilabilecegi kanaatindeyiz. ABSTRACT Patent ductus arteriosus (PDA) causing large left-to-right shunts causes considerable mortality and morbidity in very low birth weight (VLBW) preterm infants. If medical treatment fails or contraindicated, surgical ligation is performed. There is no consensus about doing this operation in the surgery room or newborn intensive care unit (NICU) and what are the ideal anesthetic agents. In this case report, we discussed anesthetic management during ligation of PDA in a VLBW preterm infant who has serious cardiac, pulmonary and renal failure. A 8 days old preterm infant weighing 775 grams with respiratory distress syndrome, serious pneumonia and renal failure had surgical ligation through left thoracotomy in open bed in the operating theatre. Ketamine was used for anesthesia induction and maintenance, neither muscle relaxant nor inhalational agents preferred. There was hypersecretion, desaturation and bradycardia during operation. Bradycardia and low blood pressure was managed by iv adrenaline, postoperatively patient was transferred to NICU. We believe that VLBW preterm infants by having multiple system failure may have PDA ligation in operating room if there is no optimum conditions in ICU by obtaining safe transport, performing ketamine in anesthesia induction and maintenance. |
| Databáze: | OpenAIRE |
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