Protocol for the anesthetic management of the maternal-fetal binomial in the EXIT project for neonates with diaphragmatic hernia

Fuentes-García, Víctor Edmundo; Alarcón-Almanza, Juan Manuel; Maldonado-Sánchez, Kelly Arlett; Contreras-Ramírez, Nathalie

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Revista mexicana de anestesiología

versão impressa ISSN 0484-7903

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FUENTES-GARCIA, Víctor Edmundo; ALARCON-ALMANZA, Juan Manuel; MALDONADO-SANCHEZ, Kelly Arlett e CONTRERAS-RAMIREZ, Nathalie. Protocol for the anesthetic management of the maternal-fetal binomial in the EXIT project for neonates with diaphragmatic hernia. Rev. mex. anestesiol. [online]. 2021, vol.44, n.2, pp.91-97. Epub 04-Out-2021. ISSN 0484-7903.

The anesthetic management for this procedure is quite different from the anesthetic management of a conventional caesarean section. It includes deep general anesthesia with halogenated and narcotic administration, to get adecuate uterine relaxation and preservation of best uteroplacental flow to the fetus during anesthesia and the benefit of general anesthesia to aim the neonate show effects of of anesthetic medication by this way facilitate airway access before umbilical cord clamping. The aim to mantain placental oxigenation to neonate is avoid hypoxia risk during intubation technique. In the Hospital Infantil de Mexico «Federico Gómez» this procedures have been carried out since June 2007, however, there is still no homogeneous management.

Material and methods:

Through a case report, a perioperative files review was made of pregnant patients who were given anesthetic management for EXIT procedure in June 2007 to May 2018 period.

Results:

Of the 43 cases, the perioperative anesthetic information obtained allowed to standardize the anesthetic management of the maternal fetal binomial in order to perform an intrahospital protocol.

Conclusion:

The ability to perform a protocol for the anesthetic management of the maternal fetal binomial in the exit project allows to reduce complications and morbidity and mortality in the binomial, offering better quality of care.

Palavras-chave : EXIT procedure; neonate intubation; cesarean section anesthesia; EXIT (ex utero intrapartum therapy).

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