Abstract

BALLEN, Fanuel  and  ARRIETA, Maribel. Congenital Diaphragmatic Hernia. Rev. colomb. anestesiol. [online]. 2010, vol.38, n.2, pp.241-258. ISSN 0120-3347.

Introduction. The Congenital Diaphragmatic Hernia (CDH) is an anatomical structural defect, which allows passage of the abdominal viscera into the chest cavity resulting in morbidity from serious cardiopulmonary complications and high perioperative mortality. In the last few decades new management strategies have been developed that have helped to reduce this high mortality. Objectives. To review and analyze a clinical CDH case and its perioperative evolution, including a discussion about anesthetic and respiratory management, in addition to reviewing the latest literature on the topic. Methodology. Presentation of a clinical case Conclusions. The management of a CDH patient is multidisciplinary. An early diagnosis should be made from the pre-natal period in order to optimize management and make available the best therapeutic tools. However, despite our efforts, mortality is still high. This is a patient -35 hours after birth- presenting congenital diaphragmatic hernia and at birth was managed at the neonatal intensive care unit with freorotracheal intubation, assisted mechanical ventilation, and inotropic and vasopressor support. Then the patient was taken to the OR to undergo corrective surgery for the diaphragmatic defect. The anesthetic and respiratory management is discussed together with a brief literature review.

Keywords : Diaphragmatic hernia; congenital anomalies; surgery; anesthesia.

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