Near demise of a child with Prader-Willi syndrome during elective orchidopexy.
The case of a morbidly obese 3.5-year-old boy, with Prader-Willi syndrome (PWS), who experienced a life-threatening episode of pulmonary edema soon after induction of general anesthesia with sevoflurane and intubation for orchidopexy is presented. The patient who had history of sleep apnea and who had an uneventful laparoscopy under general anesthesia 6 months previously was supported with mechanical ventilation with positive end expiratory pressure but developed hyperthermia, pneumonia, sepsis, and Acute Respiratory Distress Syndrome in the intensive care unit. He recovered fully 11 days after surgery. The possible contributing factors for the development of pulmonary edema are discussed. Arrangements for monitoring in an intensive care setting after surgery are highly recommended for patients with PWS.
Mantadakis
Elpis
E
Department of Pediatrics, Intensive Care Unit, University Hospital of Heraklion, Heraklion, Crete, Greece.
Spanaki
Anna-Maria
AM
Geromarkaki
Elsa
E
Vassilaki
Efrosini
E
Briassoulis
George
G
D000768:Anesthesia, General; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation; D002675:Child, Preschool; D017558:Elective Surgical Procedures; D006801:Humans; D015278:Intensive Care Units, Pediatric; D010535:Laparoscopy; D008297:Male; D008738:Methyl Ethers; D008991:Monitoring, Physiologic; D009767:Obesity, Morbid / Q000150:complications; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D011218:Prader-Willi Syndrome / Q000150:complications*; D011654:Pulmonary Edema / Q000209:etiology*; D000077149:Sevoflurane; D012891:Sleep Apnea Syndromes; D013737:Testis / Q000601:surgery*
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane