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BMC Anesthesiology
Published in: BMC Anesthesiology 1/2020

01-12-2020 | Thoracoscopy | Case report

Anesthesia management in neonatal congenital bronchobiliary fistula: case report and literature review

Authors: Hong Yin, Guangyi Zhao, Yingjie Du, Ping Zhao

Published in: BMC Anesthesiology | Issue 1/2020

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Abstract

Background

There is very little published literature and none that discussed care in a neonate regarding anesthetic risk and management of neonate with congenital bronchobiliary fistula during thoracoscopy and thoracotomy. This article analyzes related risk factors and literature review from perioperative ventilation, circulation and other aspects of management.

Case presentation

A neonate diagnosed as congenital bronchobiliary fistula combined with severe chemical pneumonia, consolidation of the lungs, and infection was facing the risk of anaesthesia under thoracoscopy exploration surgery, who experiened more than 20 days diagnostic period before operation. Many risk factors have led to conversion from minimally invasive surgery to thoracotomy, including persistent hypoxemia, hypercapnia, difficult surgical exposure and extremly difficulty of intraoperative ventilation management. Anesthesia maintenance after conversion to open access remained problematic. Fortunately the patient showed no sign of any adverse CNS effects after 4 months of follow-up.

Conclusions

The most prominent anesthesia challenges are hypoxemia, increased airway resistance, impaired ventilation, and the risk of metabolic acidosis. Close cooperation among the entire neonatal medical team is the key factors in successful management of this rare case.
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Metadata
Title
Anesthesia management in neonatal congenital bronchobiliary fistula: case report and literature review
Authors
Hong Yin
Guangyi Zhao
Yingjie Du
Ping Zhao
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2020
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-020-01052-4

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