There is very little published literature and none that discussed care in a neonate regarding\nanesthetic risk and management of neonate with congenital bronchobiliary fistula during thoracoscopy and\nthoracotomy. This article analyzes related risk factors and literature review from perioperative ventilation, circulation\nand other aspects of management.\nCase presentation: A neonate diagnosed as congenital bronchobiliary fistula combined with severe chemical\npneumonia, consolidation of the lungs, and infection was facing the risk of anaesthesia under thoracoscopy\nexploration surgery, who experiened more than 20 days diagnostic period before operation. Many risk factors have\nled to conversion from minimally invasive surgery to thoracotomy, including persistent hypoxemia, hypercapnia,\ndifficult surgical exposure and extremly difficulty of intraoperative ventilation management. Anesthesia maintenance\nafter conversion to open access remained problematic. Fortunately the patient showed no sign of any adverse CNS\neffects after 4 months of follow-up.\nConclusions: The most prominent anesthesia challenges are hypoxemia, increased airway resistance, impaired\nventilation, and the risk of metabolic acidosis. Close cooperation among the entire neonatal medical team is the\nkey factors in successful management of this rare case.
Loading....