Post-herniorrhaphy extubation technique in pediatric patient with congenital diaphragmatic hernia and VACTERL association: A case report

Iracily, Diajeng Putri and Rusmawatiningtyas, Desy and Makrufardi, Firdian and Kumara, Intan Fatah and Nurnaningsih, Nurnaningsih and Moeljono, Edy (2021) Post-herniorrhaphy extubation technique in pediatric patient with congenital diaphragmatic hernia and VACTERL association: A case report. Annals of Medicine and Surgery, 69. ISSN 20490801

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Abstract

Introduction: and importance: Congenital diaphragmatic hernia (CDH) is a condition characterized by a defect in the diaphragm causing protrusion of abdominal organs into the thoracic cavity. Comprehensive management, definitive surgical procedures and postoperative care are able to significantly reduce morbidity and mortality in post-herniorrhaphy patients. Here, we reported a case of post herniorrhaphy pediatric patient with a challenge in extubation. Case presentation: A 4-month-old girl with a chief complaint of respiratory distress from was admitted to our Pediatric Intensive Care Unit. The diagnosis of diaphragmatic hernia was confirmed through small bowel follow-through radiological examination. Definitive treatment of laparotomy and herniorrhaphy were then done. The special technique for extubation was applied. Currently, the patient survives without any sequelae awaiting stoma closure. Clinical discussion: Extubation is the removal of an endotracheal tube when it is no longer needed. In mechanically ventilated patients, extubation can be performed in two ways, either using the tracheal suction catheter (TSC) or positive pressure breath (PPB) techniques. Studies show that the PBB extubation technique has better patient outcomes compared to the TSC technique. However, the TSC technique is more commonly done by medical professionals. We used the PPB technique because there were recurrent atelectases in the left lung. Conclusion: This case report illustrates extubation technique in a post-herniorrhaphy patient with congenital diaphragmatic hernia and VACTERL association. Moreover, several options of extubation techniques can be used for extubation procedure in pediatric patient with CDH. © 2021

Item Type: Article
Additional Information: Cited by: 1; All Open Access, Gold Open Access
Uncontrolled Keywords: amlodipine; antibiotic agent; epinephrine; methylprednisolone; spironolactone; anorectal malformation; Article; atelectasis; blood gas analysis; case report; cesarean section; clinical article; colostomy; computer assisted tomography; congenital diaphragm hernia; congenital malformation; disseminated intravascular clotting; echocardiography; extubation; female; herniorrhaphy; human; infant; laparotomy; larynx edema; patent foramen ovale; pneumonia; positive pressure ventilation; postoperative care; rectovaginal fistula; respiratory distress; sepsis; septic shock; stridor; syndrome VATER; thorax radiography; ultrasound; ventilator associated pneumonia
Subjects: R Medicine > RB Biomedical Sciences
Divisions: Faculty of Medicine, Public Health and Nursing > Public Health and Nutrition
Depositing User: Sri JUNANDI
Date Deposited: 27 Sep 2024 01:08
Last Modified: 27 Sep 2024 01:08
URI: https://ir.lib.ugm.ac.id/id/eprint/4573

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