Abstract

Bronchopulmonary dysplasia (BPD) is the most frequently diagnosed chronic lung disease in premature infants. The disease is characterized by an arrest in lung tissue growth and tissue inflammation leading to increased pulmonary vascular resistance, impaired gas exchange, and increased airway reactivity. These patients are at an increased risk of developing perioperative respiratory adverse events such as laryngospasm, bronchospasm, and oxygen desaturation. Strides in neonatal care have resulted in more patients with the diagnosis to present to the operating room to undergo general anesthesia. The intraoperative management of this patient population has not been extensively researched. A 16-month, 9.6 kg male with a medical history of BPD, asthma, OSA, and premature birth at 27 weeks presented to the operating room for a direct laryngoscopy and adenoidectomy. The procedure ensued uneventfully, and the patient was transferred to the post anesthesia care unit with O2 6L/min via blow by. Upon arrival, the patient became tachypneic and displayed suprasternal and substernal retractions. He experienced a severe bronchospasm that resulted in cardiopulmonary resuscitation. After several attempts to re-intubate, an airway was secured, and bag mask ventilation initiated followed by the return of spontaneous circulation. The patient was transferred to the pediatric intensive care unit for further stabilization. He was weaned to room air within 12 hours and discharged home the following day. In children with BPD, does integration of a perioperative protocol for optimization of respiratory function decrease the risk of adverse events when compared to the usual standard of care?

Author Details

Adriana Comerford, BSN; Lisa Herbinger, DNP, CRNA

Sigma Membership

Non-member

Lead Author Affiliation

Samford University, Birmingham, Alabama, USA

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Case Study/Series

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Bronchopulmonary Dysplasia, Pediatric Respiratory Adverse Events, Perioperative Protocol Bronchospasm

Advisor

Herbinger, Lisa

Degree

DNP

Degree Grantor

Samford University

Degree Year

2024

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Self-submission

Date of Issue

2024-01-26

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