A Case of Severe Necrotizing Enterocolitis with High-Frequency Oscillatory Ventilation-Assisted Breathing Anesthesia Experience Sharing

Lin Song; Xuejie Li

doi:doi:10.11648/j.ajp.20230904.17

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A Case of Severe Necrotizing Enterocolitis with High-Frequency Oscillatory Ventilation-Assisted Breathing Anesthesia Experience Sharing

Lin Song, Xuejie Li^*

Published in American Journal of Pediatrics (Volume 9, Issue 4)

Received: 24 November 2023 Accepted: 8 December 2023 Published: 18 December 2023

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Abstract

We report a case of a 27-week premature infant with necrotizing enterocolitis 28 days postpartum who underwent high-frequency oscillation-assisted ventilation anesthesia during surgery. Children born after the whole body's skin is blue, spontaneous breathing is weak, with a sigh breath, limb soft, oxygen desaturation under endotracheal intubation-assisted ventilation into the NICU. On the 20th day after the birth of children, abdominal distension sign of progression, merger, NEC. 22 days after birth oxygen saturation fluctuations in 80% to 90%, blood gas analysis in children with prompt acidosis is obvious, to correct acidosis, baking soda, at the same time with PaCO₂ prompt rise obviously, sputum, mechanical ventilation has been unable to maintain oxygenation, has been into high-frequency respirator assisted ventilation, respiratory frequency of 9 HZ, sputum suction, abdominal X-ray signs of intestinal obstruction, pediatric surgical consultation to laparotomy. Visit poor children to see children before anesthesia, bronze skin, through the mouth insert 3.5 endotracheal intubation mechanical assisted ventilation, abdominal plain film hint of peng of the children with abdominal significantly, abdominal veins, visible gastrointestinal type, high tension. Breathing machine Chang Pin ventilation by putting the children into the operating room, home bed immediately after connecting high-frequency ventilation, line ECG noninvasive arterial blood pressure SPO₂ (onset of each one) percutaneous CO₂ monitoring temperature monitoring of cerebral oxygen saturation monitoring. Intraoperative heat preservation, blood transfusion, and rehydration, sputum suction strong heart, in order to maintain stable hemodynamics and adjust the internal environment stable. The operation lasted only 38 minutes, safely back to NICU, put the patient on the evening the postoperative respiratory machine model had a high-frequency mode to Chang Pin auxiliary breathing machine, the second day postoperatively, children with open and body moving, stopped using positive inotropic drugs, continue to have a breathing machine auxiliary breath, at the same time strengthen parenteral nutrition support and anti-infection treatment, postoperative 3 months into the common ward, five months after hospital discharge. High-frequency oscillatory ventilation provides a new respiratory support method for newborns suffering from necrotizing enterocolitis, especially premature infants, and also buys valuable time for their subsequent treatment.

Published in	American Journal of Pediatrics (Volume 9, Issue 4)
DOI	10.11648/j.ajp.20230904.17
Page(s)	231-234
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Neonatal Necrotizing Enterocolitis, High-Frequency Oscillatory Ventilation, Anesthesia Management

References

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[2]	Cai X, Liebe H L, Golubkova A, et al. A Review of the Diagnosis and Treatment of Necrotizing Enterocolitis [J]. Current Pediatric Reviews, 2023, 19 (3): 285-295.
[3]	Mϋller M J, Paul T, Seeliger S. Necrotizing enterocolitis in premature infants and newborns [J]. Journal of neonatal-perinatal medicine, 2016, 9 (3): 233-242.
[4]	Munaco A J, Veenstra M, Brownie E, et al. Timing of optimal surgical intervention for neonates with necrotizing enterocolitis [J]. The american surgeon, 2015, 81 (5): 438-443.
[5]	De Bernardo G, Sordino D, De Chiara C, et al. Management of NEC: Surgical Treatment and Role of Traditional X-rayVersus Ultrasound Imaging, Experience of a Single Centre [J]. Current Pediatric Reviews, 2019, 15 (2): 125-130.
[6]	Van Heesewijk A E, Rush M L, Schmidt B, et al. Agreement between study designs: a systematic review comparing observational studies and randomized trials of surgical treatments for necrotizing enterocolitis [J]. The Journal of Maternal-Fetal & Neonatal Medicine, 2020, 33 (12): 1965-1973.
[7]	Miller A G, Bartle R M, Rehder K J. High-frequency jet ventilation in neonatal and pediatric subjects: a narrative review [J]. Respiratory Care, 2021, 66 (5): 845-856.
[8]	Elgin T G, Stanford A H, Klein J M. First intention high-frequency jet ventilation for periviable infants [J]. Current opinion in pediatrics, 2022, 34 (2): 165-169.
[9]	Ethawi Y H, Abou Mehrem A, Minski J, et al. High frequency jet ventilation versus high frequency oscillatory ventilation for pulmonary dysfunction in preterm infants [J]. Cochrane Database of Systematic Reviews, 2016 (5).
[10]	Wheeler C R, Smallwood C D, O'Donnell I, et al. Assessing initial response to high-frequency jet ventilation in premature infants with hypercapnic respiratory failure [J]. Respiratory Care, 2017, 62 (7): 867-872.
[11]	Carr B D, Gadepalli S K. Does surgical management alter outcome in necrotizing enterocolitis? [J]. Clinics in Perinatology, 2019, 46 (1): 89-100.
[12]	Lemons J A, Bauer C R, Oh W, et al. Very low birth weight outcomes of the National Institute of Child health and human development neonatal research network, January 1995 through December 1996 [J]. Pediatrics, 2001, 107 (1): E1.
[13]	Sweet D G, Carnielli V, Greisen G, et al. European consensus guidelines on the management of respiratory distress syndrome–2019 update [J]. Neonatology, 2019, 115 (4): 432-450.
[14]	Sánchez-Luna M, González-Pacheco N, Belik J, et al. New ventilator strategies: high-frequency oscillatory ventilation combined with volume guarantee [J]. American journal of perinatology, 2018, 35 (06): 545-548.
[15]	Miller A G, Tan H L, Smith B J, et al. The physiological basis of high-frequency oscillatory ventilation and current evidence in adults and children: a narrative review [J]. Frontiers in Physiology, 2022, 13: 808.

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APA Style

Song, L., Li, X. (2023). A Case of Severe Necrotizing Enterocolitis with High-Frequency Oscillatory Ventilation-Assisted Breathing Anesthesia Experience Sharing. American Journal of Pediatrics, 9(4), 231-234. https://doi.org/10.11648/j.ajp.20230904.17

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ACS Style

Song, L.; Li, X. A Case of Severe Necrotizing Enterocolitis with High-Frequency Oscillatory Ventilation-Assisted Breathing Anesthesia Experience Sharing. Am. J. Pediatr. 2023, 9(4), 231-234. doi: 10.11648/j.ajp.20230904.17

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AMA Style

Song L, Li X. A Case of Severe Necrotizing Enterocolitis with High-Frequency Oscillatory Ventilation-Assisted Breathing Anesthesia Experience Sharing. Am J Pediatr. 2023;9(4):231-234. doi: 10.11648/j.ajp.20230904.17

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@article{10.11648/j.ajp.20230904.17,
  author = {Lin Song and Xuejie Li},
  title = {A Case of Severe Necrotizing Enterocolitis with High-Frequency Oscillatory Ventilation-Assisted Breathing Anesthesia Experience Sharing},
  journal = {American Journal of Pediatrics},
  volume = {9},
  number = {4},
  pages = {231-234},
  doi = {10.11648/j.ajp.20230904.17},
  url = {https://doi.org/10.11648/j.ajp.20230904.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20230904.17},
  abstract = {We report a case of a 27-week premature infant with necrotizing enterocolitis 28 days postpartum who underwent high-frequency oscillation-assisted ventilation anesthesia during surgery. Children born after the whole body's skin is blue, spontaneous breathing is weak, with a sigh breath, limb soft, oxygen desaturation under endotracheal intubation-assisted ventilation into the NICU. On the 20th day after the birth of children, abdominal distension sign of progression, merger, NEC. 22 days after birth oxygen saturation fluctuations in 80% to 90%, blood gas analysis in children with prompt acidosis is obvious, to correct acidosis, baking soda, at the same time with PaCO2 prompt rise obviously, sputum, mechanical ventilation has been unable to maintain oxygenation, has been into high-frequency respirator assisted ventilation, respiratory frequency of 9 HZ, sputum suction, abdominal X-ray signs of intestinal obstruction, pediatric surgical consultation to laparotomy. Visit poor children to see children before anesthesia, bronze skin, through the mouth insert 3.5 endotracheal intubation mechanical assisted ventilation, abdominal plain film hint of peng of the children with abdominal significantly, abdominal veins, visible gastrointestinal type, high tension. Breathing machine Chang Pin ventilation by putting the children into the operating room, home bed immediately after connecting high-frequency ventilation, line ECG noninvasive arterial blood pressure SPO2 (onset of each one) percutaneous CO2 monitoring temperature monitoring of cerebral oxygen saturation monitoring. Intraoperative heat preservation, blood transfusion, and rehydration, sputum suction strong heart, in order to maintain stable hemodynamics and adjust the internal environment stable. The operation lasted only 38 minutes, safely back to NICU, put the patient on the evening the postoperative respiratory machine model had a high-frequency mode to Chang Pin auxiliary breathing machine, the second day postoperatively, children with open and body moving, stopped using positive inotropic drugs, continue to have a breathing machine auxiliary breath, at the same time strengthen parenteral nutrition support and anti-infection treatment, postoperative 3 months into the common ward, five months after hospital discharge. High-frequency oscillatory ventilation provides a new respiratory support method for newborns suffering from necrotizing enterocolitis, especially premature infants, and also buys valuable time for their subsequent treatment.
},
 year = {2023}
}

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TY  - JOUR
T1  - A Case of Severe Necrotizing Enterocolitis with High-Frequency Oscillatory Ventilation-Assisted Breathing Anesthesia Experience Sharing
AU  - Lin Song
AU  - Xuejie Li
Y1  - 2023/12/18
PY  - 2023
N1  - https://doi.org/10.11648/j.ajp.20230904.17
DO  - 10.11648/j.ajp.20230904.17
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 231
EP  - 234
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20230904.17
AB  - We report a case of a 27-week premature infant with necrotizing enterocolitis 28 days postpartum who underwent high-frequency oscillation-assisted ventilation anesthesia during surgery. Children born after the whole body's skin is blue, spontaneous breathing is weak, with a sigh breath, limb soft, oxygen desaturation under endotracheal intubation-assisted ventilation into the NICU. On the 20th day after the birth of children, abdominal distension sign of progression, merger, NEC. 22 days after birth oxygen saturation fluctuations in 80% to 90%, blood gas analysis in children with prompt acidosis is obvious, to correct acidosis, baking soda, at the same time with PaCO2 prompt rise obviously, sputum, mechanical ventilation has been unable to maintain oxygenation, has been into high-frequency respirator assisted ventilation, respiratory frequency of 9 HZ, sputum suction, abdominal X-ray signs of intestinal obstruction, pediatric surgical consultation to laparotomy. Visit poor children to see children before anesthesia, bronze skin, through the mouth insert 3.5 endotracheal intubation mechanical assisted ventilation, abdominal plain film hint of peng of the children with abdominal significantly, abdominal veins, visible gastrointestinal type, high tension. Breathing machine Chang Pin ventilation by putting the children into the operating room, home bed immediately after connecting high-frequency ventilation, line ECG noninvasive arterial blood pressure SPO2 (onset of each one) percutaneous CO2 monitoring temperature monitoring of cerebral oxygen saturation monitoring. Intraoperative heat preservation, blood transfusion, and rehydration, sputum suction strong heart, in order to maintain stable hemodynamics and adjust the internal environment stable. The operation lasted only 38 minutes, safely back to NICU, put the patient on the evening the postoperative respiratory machine model had a high-frequency mode to Chang Pin auxiliary breathing machine, the second day postoperatively, children with open and body moving, stopped using positive inotropic drugs, continue to have a breathing machine auxiliary breath, at the same time strengthen parenteral nutrition support and anti-infection treatment, postoperative 3 months into the common ward, five months after hospital discharge. High-frequency oscillatory ventilation provides a new respiratory support method for newborns suffering from necrotizing enterocolitis, especially premature infants, and also buys valuable time for their subsequent treatment.

VL  - 9
IS  - 4
ER  -

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Author Information

Lin Song

Department of Anesthesiology, West China Hospital, Sichuan University and the Research Units of West China (2018RU012), Chinese Academy of Medical Sciences, Chengdu, China

Contact Email
Xuejie Li

Department of Anesthesiology, West China Hospital, Sichuan University and the Research Units of West China (2018RU012), Chinese Academy of Medical Sciences, Chengdu, China

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Plain Text BibTeX RIS

APA Style

Song, L., Li, X. (2023). A Case of Severe Necrotizing Enterocolitis with High-Frequency Oscillatory Ventilation-Assisted Breathing Anesthesia Experience Sharing. American Journal of Pediatrics, 9(4), 231-234. https://doi.org/10.11648/j.ajp.20230904.17

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ACS Style

Song, L.; Li, X. A Case of Severe Necrotizing Enterocolitis with High-Frequency Oscillatory Ventilation-Assisted Breathing Anesthesia Experience Sharing. Am. J. Pediatr. 2023, 9(4), 231-234. doi: 10.11648/j.ajp.20230904.17

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AMA Style

Song L, Li X. A Case of Severe Necrotizing Enterocolitis with High-Frequency Oscillatory Ventilation-Assisted Breathing Anesthesia Experience Sharing. Am J Pediatr. 2023;9(4):231-234. doi: 10.11648/j.ajp.20230904.17

Copy | Download

@article{10.11648/j.ajp.20230904.17,
  author = {Lin Song and Xuejie Li},
  title = {A Case of Severe Necrotizing Enterocolitis with High-Frequency Oscillatory Ventilation-Assisted Breathing Anesthesia Experience Sharing},
  journal = {American Journal of Pediatrics},
  volume = {9},
  number = {4},
  pages = {231-234},
  doi = {10.11648/j.ajp.20230904.17},
  url = {https://doi.org/10.11648/j.ajp.20230904.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20230904.17},
  abstract = {We report a case of a 27-week premature infant with necrotizing enterocolitis 28 days postpartum who underwent high-frequency oscillation-assisted ventilation anesthesia during surgery. Children born after the whole body's skin is blue, spontaneous breathing is weak, with a sigh breath, limb soft, oxygen desaturation under endotracheal intubation-assisted ventilation into the NICU. On the 20th day after the birth of children, abdominal distension sign of progression, merger, NEC. 22 days after birth oxygen saturation fluctuations in 80% to 90%, blood gas analysis in children with prompt acidosis is obvious, to correct acidosis, baking soda, at the same time with PaCO2 prompt rise obviously, sputum, mechanical ventilation has been unable to maintain oxygenation, has been into high-frequency respirator assisted ventilation, respiratory frequency of 9 HZ, sputum suction, abdominal X-ray signs of intestinal obstruction, pediatric surgical consultation to laparotomy. Visit poor children to see children before anesthesia, bronze skin, through the mouth insert 3.5 endotracheal intubation mechanical assisted ventilation, abdominal plain film hint of peng of the children with abdominal significantly, abdominal veins, visible gastrointestinal type, high tension. Breathing machine Chang Pin ventilation by putting the children into the operating room, home bed immediately after connecting high-frequency ventilation, line ECG noninvasive arterial blood pressure SPO2 (onset of each one) percutaneous CO2 monitoring temperature monitoring of cerebral oxygen saturation monitoring. Intraoperative heat preservation, blood transfusion, and rehydration, sputum suction strong heart, in order to maintain stable hemodynamics and adjust the internal environment stable. The operation lasted only 38 minutes, safely back to NICU, put the patient on the evening the postoperative respiratory machine model had a high-frequency mode to Chang Pin auxiliary breathing machine, the second day postoperatively, children with open and body moving, stopped using positive inotropic drugs, continue to have a breathing machine auxiliary breath, at the same time strengthen parenteral nutrition support and anti-infection treatment, postoperative 3 months into the common ward, five months after hospital discharge. High-frequency oscillatory ventilation provides a new respiratory support method for newborns suffering from necrotizing enterocolitis, especially premature infants, and also buys valuable time for their subsequent treatment.
},
 year = {2023}
}

Copy | Download

TY  - JOUR
T1  - A Case of Severe Necrotizing Enterocolitis with High-Frequency Oscillatory Ventilation-Assisted Breathing Anesthesia Experience Sharing
AU  - Lin Song
AU  - Xuejie Li
Y1  - 2023/12/18
PY  - 2023
N1  - https://doi.org/10.11648/j.ajp.20230904.17
DO  - 10.11648/j.ajp.20230904.17
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 231
EP  - 234
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20230904.17
AB  - We report a case of a 27-week premature infant with necrotizing enterocolitis 28 days postpartum who underwent high-frequency oscillation-assisted ventilation anesthesia during surgery. Children born after the whole body's skin is blue, spontaneous breathing is weak, with a sigh breath, limb soft, oxygen desaturation under endotracheal intubation-assisted ventilation into the NICU. On the 20th day after the birth of children, abdominal distension sign of progression, merger, NEC. 22 days after birth oxygen saturation fluctuations in 80% to 90%, blood gas analysis in children with prompt acidosis is obvious, to correct acidosis, baking soda, at the same time with PaCO2 prompt rise obviously, sputum, mechanical ventilation has been unable to maintain oxygenation, has been into high-frequency respirator assisted ventilation, respiratory frequency of 9 HZ, sputum suction, abdominal X-ray signs of intestinal obstruction, pediatric surgical consultation to laparotomy. Visit poor children to see children before anesthesia, bronze skin, through the mouth insert 3.5 endotracheal intubation mechanical assisted ventilation, abdominal plain film hint of peng of the children with abdominal significantly, abdominal veins, visible gastrointestinal type, high tension. Breathing machine Chang Pin ventilation by putting the children into the operating room, home bed immediately after connecting high-frequency ventilation, line ECG noninvasive arterial blood pressure SPO2 (onset of each one) percutaneous CO2 monitoring temperature monitoring of cerebral oxygen saturation monitoring. Intraoperative heat preservation, blood transfusion, and rehydration, sputum suction strong heart, in order to maintain stable hemodynamics and adjust the internal environment stable. The operation lasted only 38 minutes, safely back to NICU, put the patient on the evening the postoperative respiratory machine model had a high-frequency mode to Chang Pin auxiliary breathing machine, the second day postoperatively, children with open and body moving, stopped using positive inotropic drugs, continue to have a breathing machine auxiliary breath, at the same time strengthen parenteral nutrition support and anti-infection treatment, postoperative 3 months into the common ward, five months after hospital discharge. High-frequency oscillatory ventilation provides a new respiratory support method for newborns suffering from necrotizing enterocolitis, especially premature infants, and also buys valuable time for their subsequent treatment.

VL  - 9
IS  - 4
ER  -

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