Monitoreo hemodinámico y capnográfico durante la ligadura quirúrgica del conducto arterioso persistente en un neonato prematuro extremo: reporte de caso y revisión de la literatura
Year: 2026
Type: article
Study design: Case Report
Abstract: Introduction: Patent ductus arteriosus (PDA) is one of the most common heart defects in premature neonates. Surgical closure can cause sudden changes in preload, afterload, and systemic perfusion, leading to perioperative hemodynamic and respiratory instability that requires continuous monitoring. Case report: A very preterm female neonate (gestational age: 30 weeks), 17 days old and weighing 1,100 g (birth weight: 1,010 g), presented with a hemodynamically significant PDA and associated complications (pneumonia, a previously drained pneumothorax, and acute renal failure), scheduled for surgical closure via left minithoracotomy. Anesthetic management included controlled mechanical ventilation, pre- and post-ductal oxygen saturation monitoring, temperature, non-invasive blood pressure, heart rate, perfusion index, a 3-lead electrocardiogram, and capnography. Discussion: Following ductal ligation, transient changes were observed: a decrease in pre- and post-ductal saturation, a temporary increase in oxygen requirements, and a moderate drop in blood pressure requiring a temporary noradrenaline adjustment; ETCO2, temperature, and heart rate remained stable. The patient was transferred to the neonatal intensive care unit intubated, receiving intravenous vasopressors, and progressed favorably by 48 hours. Conclusions: Surgical ligation of PDA in very preterm infants can be associated with transient hemodynamic and ventilatory alterations requiring close monitoring. Adjustments to FiO2 and noradrenaline were guided by pre- and post-ductal oximetry and blood pressure; ETCO2, temperature, and heart rate played a complementary, non-decisive role.
Source: ACTAS PERUANAS DE ANESTESIOLOGIA
DOI: 10.65016/zjsxma94
Language: Spanish
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7214969766