title: Severe bronchial hyperreactivity as a sequel to congenital diaphragmatic hernia.
abstract: Bronchial hyperreactivity may be a sequel to congenital diaphragmatic hernia (CDH). V/Q-mismatch in these patients may aggravate the condition. A case history is presented of a 20-month-old girl, who on the second day of life survived surgery for a left CDH. Adrenaline intratracheally via the nasotracheal tube was given to break a condition of refractory bronchospasm and desaturation. In the case of refractory bronchospasm and desaturation adrenaline may be helpful due to its alpha-receptor stimulation as this may inhibit bronchoconstriction, improve the V/Q mismatch and reduce pulmonary vascular resistance and mucosal swelling.
authors.affiliation: Department of Nephrology, Odense Universitetshospital, Denmark.
authors.forename: S G
authors.initials: SG
authors.lastname: Skousgaard
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D016535:Bronchial Hyperreactivity / Q000209:etiology* / Q000517:prevention & control; D004837:Epinephrine / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006548:Hernia, Diaphragmatic / Q000503:physiopathology / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000517:prevention & control; D007223:Infant; D012121:Respiration, Artificial; D014692:Ventilation-Perfusion Ratio
chemical_list: D000316:Adrenergic alpha-Agonists; D004837:Epinephrine