RESUMO
We report a case of near drowning of a 3-year-old girl, who was admitted to our emergency room with a core temperature of 18.4 degrees C. After rewarming on cardiopulmonary bypass and restitution of her circulation, respiratory failure resistant to conventional respiratory therapy prohibited weaning from cardiopulmonary bypass. Therefore, we instituted extracorporeal membrane oxygenation (ECMO). Fifteen hours later, she could be weaned from ECMO but required assisted ventilation for another 12 days. Twenty months later there are no neurologic deficits.
Assuntos
Reanimação Cardiopulmonar , Oxigenação por Membrana Extracorpórea , Afogamento Iminente/terapia , Insuficiência Respiratória/terapia , Ponte Cardiopulmonar , Pré-Escolar , Feminino , Seguimentos , Humanos , Hipotermia/terapia , ReaquecimentoRESUMO
The case of a 680 g premature baby who developed massive spontaneous liver haemorrhage during laparotomy for necrotizing enterocolitis is reported. The infant survived due to rapid and massive fluid administration, including transfusion of large volumes of blood and blood products, in combination with high dose inotropic support and the surgical use of packing with thrombostatic sponges. Good venous access, including two central venous lines, turned out to be very useful.
Assuntos
Anestesia Geral , Enterocolite Necrosante/cirurgia , Hemorragia/etiologia , Doenças do Prematuro/cirurgia , Recém-Nascido Prematuro , Cuidados Intraoperatórios , Complicações Intraoperatórias/terapia , Laparotomia , Hepatopatias/etiologia , Transfusão de Sangue , Cardiotônicos/uso terapêutico , Cateterismo Venoso Central/instrumentação , Cateterismo Periférico/instrumentação , Feminino , Hidratação , Hemorragia/terapia , Hemostasia Cirúrgica/instrumentação , Hemostasia Cirúrgica/métodos , Humanos , Recém-Nascido , Hepatopatias/terapia , Tampões de Gaze CirúrgicosRESUMO
A case of multiple life-threatening postoperative apnoeas in a term neonate undergoing inguinal herniorrhaphy and orchidopexy who received light inhalation anaesthesia combined with caudal block with 1 ml.kg-1 ropivacaine 0.2% plus 2 microg.kg-1 clonidine is reported. The patient showed no apparent risk factors for postanaesthetic apnoea. Oxycardiorespirography five days after surgery only showed minor abnormalities. Clonidine though administered caudally in the usual dose of 2 microg.kg-1 appeared to be the most likely cause for postanaesthetic apnoea in this neonate.
