Abstract
One year old patient followed with tetralogy of fallot (TOF) was admitted to our service for surgical repair. Ventricular septal defect (VSD) was repaired with a Dacron patch. The infundibular muscle was resected to allow for unobstructed flow of blood to the pulmonary valve and the area above the pulmonary valve was opened with a polytetrafluoroethylene (PTFE) patch. The patient was intubated three times bacause of the atelectasis ocurred in the lungs after the surgery. Atelectasis was treated with nebulised dornase alpha. It avoided the recurrence of atelectasis and the patient was discharged.
Highlights
The prevalence of congenital heart disease (CHD) is between 8 and 10 children per 1000 live births
Pulmonary complications of postoperative pediatric cardiac surgery observed in the study of Felcar et al where: atelectasis, pneumonia, pleural effusion, pneumothorax, chylothorax, pulmonary hypertension, pulmonary haemorrhage and diaphragmatic paralysis, whereas the first two aforementioned complications are the more common ones [2]
Heart surgeries associated with CPB have as adverse effect the increased capillary permeability that causes edema, which results in decreased lung compliance and gas exchange [6], in addition to lead to airway obstruction, atelectasis, decreased functional residual capacity and, hypoxemia [5]
Summary
The prevalence of congenital heart disease (CHD) is between 8 and 10 children per 1000 live births. Pulmonary complications are the most common causes of morbidity and mortality in the postoperative period after congenital heart surgery Both mechanical and gas exchange abnormalities result in increased ventilator requirements, intensive care unit (ICU) stay and mortality. Case One year old female patient followed with tetralogy of fallot (TOF) was admitted to our service for surgical repair. After 17 hours of intubation the atelectasis of the right lung totally recovered on chest x ray. Her oxygen saturation level was at 50% and she was intubated again Her chest x ray showed total atelectasis of the right lung. She was treated with Dornase alpha for three more days in the clinic and on the fifth day she was discharged from the hospital
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