AI Article Synopsis
- The authors describe four newborns experiencing severe anoxemia following congenital diaphragmatic hernia repair, with three showing hypoxemia from birth.
- Cardiac catheterization indicated pulmonary hypertension and fetal circulation in these patients, with some improvement in oxygenation observed after administering tolazoline, although it eventually became less effective.
- The study suggests that ductus arteriosus ligation and pulmonary vasodilators can effectively enhance oxygen levels, potentially preventing anoxic death in these critically affected infants.
Article Abstract
The authors present four new born with severe anoxemia after congenital diaphragmatic hernia repair. In three babies' hypoxemia was present from birth. Cardiac catheterization revealed pulmonary hypertension, resulting in a state of fetal circulation. Tolazoline produced an improvement in oxygenation, but became secondary ineffective. In one case ductus arteriosus was occluded during cardiac catheterization, after which immediate improvement in peripheral oxygenation was seen. Ligation of the patient ductus arteriosus was proposed in that case. In the fourth infant, hypoxemia developed secondary and was successfully treated with tolazoline. It is suggested that ligation of the patient ductus arteriosus and administration of pulmonary vasodilatators are both effective in improving oxygenation, in patients who may die an anoxic death after repair of a severe congenital diaphragmatic hernia.
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