[Impossibility of artificial ventilation in a prone position in a patient with deformity of the spine (case-history).].
The authors present the case of a 15-year-old female patient (Jehova's Witness) who was operated at the age of two on account of a Wilms' tumour of the kidney and irradiated with subsequent postirra-diation scoliosis. In 1990-1993 she was six times subjected to anaesthesia for distraction with a Harrington rod and repeated redistractions. All anaesthesias were of the general type, with artificial pulmonary ventilation in the prone position and without complications. Anaesthesiological methods and procedures were used which made it possible to avoid administration of blood or blood derivatives. In March 1993 the patient was prepared with erythropoietin for the final treatment of the deformed spine. During general anaesthesia suddenly artificial pulmonary ventilation in a prone position became impossible due to complete collapse of the trachea closely behind the end of the armed tracheal tube. After postponing the procedure, bronchoscopic and CT examination in a supine position during spontaneous respiration confirmed stenosis of the distal portion of the trachea to one third of the lumen. The authors assume that the cause are altered anatomical relations of the mediastinum caused by distraction and repeated redistractions in a field affected by irradiation. Key words: deformity of the spine, stenosis of the trachea, Jehova's Witnesses.
Cundrle
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I
Anesteziologicko-resuscitacní oddelení FNsP, Brno - Bohunice.
Vlach
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O
Ondrásková
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H