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Canadian Journal of Anaesthesia

, Volume 45, Issue 3, pp 277–279 | Cite as

Anaesthesia in Poland syndrome

  • Rajamani Sethuraman
  • Santhanagopalan Kannan
  • Indu Bala
  • Ramesh Kumar Sharma
Brief Reports
Accepted:

Abstract

Purpose

To describe the anaesthetic management of a child with Poland syndrome for CT scan.

Clinical features

An eight-month-old child presented with left upper limb hypoplasia and chest wall deformity with absence of ribs on the left side for CT scan of thorax. Pulsations of the heart could be seen along with paradoxical respiration over the defect. The trachea was intubated and the lungs ventilated manually to avoid inadequate ventilation and hypoxia.

Conclusions

The unilateral absence of ribs leads to poor development of subatmospheric pressure in the thorax and paradoxical respiration, and may cause inadequate pulmonary ventilation and hypoxia. In the present case, positive pressure ventilation was chosen to maintain ventilation during the procedure.

Keywords

Atrial Septal Defect Positive Pressure Ventilation Situs Inversus Syndactyly Dextrocardia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Objectif

Décrire la prise en charge anesthésique pour une tomodensitométrie chez un enfant présentant un syndrome de Poland.

Aspects cliniques

Un enfant de 8 mois s’est présenté pour une tomodensitométrie du thorax; il présentait une hypoplasie du membre supérieur gauche ainsi qu’une déformation de la cage thoracique causée par l’absence de côtes du côté gauche. Au niveau de ce défaut thoracique on pouvait voir les battements cardiaques ainsi que des mouvements respiratoires paradoxaux. On a eu recours à l’intubation trachéale et à la ventilation pulmonaire manuelle pour éviter une ventilation inadéquate et une hypoxie.

Conclusions

L’absence unilatérale des côtes conduit à une faible capacité de produire des pressions négatives dans le thorax entraînant une respiration paradoxale avec ventilation pulmonaire inadéquate et hypoxie. Dans ce cas, on a choisi la ventilation à pression positive pour le maintien de la ventilation durant la procédure.

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Copyright information

© Canadian Anesthesiologists 1998

Authors and Affiliations

  • Rajamani Sethuraman
    • 1
  • Santhanagopalan Kannan
    • 1
  • Indu Bala
    • 1
  • Ramesh Kumar Sharma
    • 2
  1. 1.Departments of Anaesthesia & Intensive CarePostgraduate Institute of Medical Education and ResearchChandigarhIndia
  2. 2.Departments of Plastic and Reconstructive SurgeryPostgraduate Institute of Medical Education and ResearchChandigarhIndia

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