Haga Mitsuhiro, Itoh Kanako, Ishiguro Akio, Iwamoto Yoichi, Kojima Takuro, Masutani Satoshi
Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, JPN.
Department of Pediatric Cardiology, Saitama Medical University International Medical Center, Kawagoe, JPN.
Cureus. 2023 Jul 5;15(7):e41389. doi: 10.7759/cureus.41389. eCollection 2023 Jul.
We present a case of an infant male born at 23 weeks' gestation with an interrupted aortic arch (IAA) complex. We treated the patient with hypoxic gas ventilation to address developing systemic undercirculation in the acute postnatal phase. As the symptoms of bronchopulmonary dysplasia evolved, hypoxic gas ventilation was no longer required to stabilize the hemodynamics. The patient was discharged home after undergoing the palliative surgical procedure of bilateral pulmonary artery banding and ductus arteriosus stent implantation. Although he suffered from pulmonary hypertension, it was controllable with oxygen supplementation and pulmonary vasodilators. There are limited therapeutic options available for extremely preterm infants with critical congenital heart defects (CHDs). Hypoxic gas ventilation might be considered as one of the options, with its risks taken into account, to manage extremely preterm infants with CHDs with pulmonary overcirculation before performing surgical interventions.
我们报告一例妊娠23周出生的男婴,患有主动脉弓中断(IAA)综合征。我们在出生后急性期对该患者进行了低氧气体通气治疗,以解决逐渐出现的体循环不足问题。随着支气管肺发育不良症状的演变,稳定血流动力学不再需要低氧气体通气。该患者在接受双侧肺动脉环扎和动脉导管支架植入的姑息性手术治疗后出院回家。虽然他患有肺动脉高压,但通过补充氧气和使用肺血管扩张剂可以得到控制。对于患有严重先天性心脏病(CHD)的极早产儿,可用的治疗选择有限。在进行手术干预之前,考虑到低氧气体通气的风险,可将其作为管理患有CHD且伴有肺循环过度的极早产儿的选择之一。