| Bilateral Diaphragmatic Paralysis Developed after Explo-Thoracotomy for Removal of Cystic Hygroma . |
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Shin Ok Koh, Hung Kun Oh |
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Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea. |
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| Abstract |
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The occurrence of bilateral phrenic nerve injury in infants and children, usually associated with birth trauma or cardiotnoracic surgery can present difficulty in bedside recognition. The resultant bilateral diaphragmatic pareais or paralysis usually presenting as respiratory distress of difficulty in weaning from a ventilator can aignificantly prolong and complicate the hospital course. We experienced the bilateral diaphragmatic paralysis which developed after explothora-cotomy for removal of cystic hygroma in 10-month-old-age Patient. We recognized the diaphragmatic paralysis on 0ctober 16,1986 (postoperative 14 day) via fluoroscope and tracheoastomy was performed on postoperative 23 day. Electroconduction study was done twice on postoperative 19 and 40 day, in which at first neuropraxia ant later viability of phrenic nerve was revealed. The patient's spontaneous respiration was improved on postoperative 51 day and the SIMV (synchronized intermittent mandatory ventilation) and CPAP (continuous positive airway pressure) was applied, The patient was weaned from ventilator at postoperative 61 day and transferred with better condition after ICU 88 day to general ward. |
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