Postpneumopnectomy neonate

[manberbenitez]

Dear 99 friends:

This is a case discussion, about a neonate that we received in my NICU at 45 days of life, with 34 weeks gestation initially,cesarean,Birth weight of 2000 grams, required mechanical ventilation because RDS, then complicate with pneumothorax, so he had a thorax drainage for 3 days, then he has pleural effusion,with a gramm negative infection, so he received 3 differente kinds of antibiotics, the last one was Imipenem with Vancomycin with good results initially but he had a residual pulmonary infection with cavitation with fibrosis, so he had to go to mechanical ventilation again. At this moment, the baby arrived to my NICU, we made a Tomography Scan that show us a real pulmonary damage with fibrosis, and pulmonary sequestration so my pediatric surgeon saw him, and confirm to us that the only way was to make a pneumonectomy. The surgery was ok, in the other lung ( left lung) we saw CLD images so we gave to him dexamethasone for 10 days and we took him from ventilator. 2 days after the surgery, the baby had episodes of bradycardia,pallor,and apnea, that we recover with PPI, and thsi episodes repeat frequently so we think in Postneumopnectomy Syndrome. My pediatric surgeon introduced 2 ping pong balls in the right Lung Cavity , and until today the baby is going well.

So my questions are:

What do you think about this case.

Do you have some experience in this kind of surgery.or postneumopnectomy syndrome, because we only find 1 report in literature.

Thanks for your opinions.

[manberbenitez]

Can anyone have an opinion of the case

thanks

[junaidmuhib]

HI,

It is really a rare type of surgery. i never experinced this before. I want to know about this procedure more. What ping pong balls doing physiologically in the lungs.

[manberbenitez]

Hi

I really aprreciate for your intersting. This is a very rarely surgery, and we only have 2 reports in the literature with 5 and 6 years follow up. The principal mechanism of the ping pong ball is only mechanically stabilisation of the mediastinum. First when we receive after the surgery ( without the ping pong ball) we saw that sometimes the patient suddenly turn pale, bradycardia, and hypotension, and diaphoretic so we read about this symptoms and conclude that was a postneumonectomy syndrome. we the surgery put the ping pong ball inside the chest, we have a more stable mediastinum and we dont have any more events.

thanks a lot

[JACK]

Hi seems very interesting. Could you highlight the publications in journals regarding this? Any links?

Thanks