Mark Wefers Bettink

Chapter 9 172 Fig 2. Surgical repair of congenital diaphragmatic hernia during EMCO (A) Surgical repair of esophageal atresia (B). Case 2 (figure 2B) is a male neonate, gestational age 34 weeks, birth weight 1,950 grams, with EA type C with a trachea-esophageal fistula. Surgical repair took place on day 1 of life. Skin priming time with ALA was 8 hours. The patient was positioned on the left side during surgery. Surgical compression of the lung caused hypoxia which required increasing FiO 2 from 35% to 75% to maintain peripheral saturation between 90% and 95%. Blood pressure and heart rate remained stable, rSO 2 responded on the increased FiO 2 firstly, but mitoPO 2 decreased soon after the compression started and continues to decrease from 69 mmHg at start surgery to 37 mmHg (a reduction of 47%) and restored within minutes after manipulation of the lung was finished with a mitoPO 2 up to 62mmHg at the end of the surgery.