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Iranian Journal of Pediatrics
Tehran University of Medical Sciences Press
ISSN: 1018-4406
EISSN: 2008-2150
Vol. 21, No. 1, 2011, pp. 116-120
Bioline Code: pe11021
Full paper language: English
Document type: Case Report
Document available free of charge

Iranian Journal of Pediatrics, Vol. 21, No. 1, 2011, pp. 116-120

 en Early Surgical Intervention for Diaphragmatic Paralysis in a Neonate; Report of a Case and Literature Review
Ahmadpour-Kacho, Mousa; Zahedpasha, Yadollah; Hadipoor, Abbas & Akbarian-Rad, Zahra

Abstract

Background: Diaphragmatic paralysis in newborns is related to brachial plexus palsy. It can cause respiratory failure necessitating prolonged mechanical ventilation and subsequent extubation failure.
Case Presentation: We present a two-hour-old male newborn with a birth weight of 4500 grams who had a right-sided brachial plexus palsy and right diaphragmatic paralysis due to shoulder dystocia. He developed respiratory distress due to isolated paralysis of the right hemi diaphragm. The clinical course was progressive, his condition worsening despite oxygen application. Physical examination, chest X-rays and M-mode ultrasonography of the diaphragm confirmed the diagnosis diaphragmatic paralysis. Surgical plication of diaphragm was done earlier than the usual time because of recurrent extubation failure. Diaphragmatic plication led to rapid improvement of pulmonary function and allowed discontinuation of mechanical ventilation in less than 3 days.
Conclusion: Early diaphragmatic plication enhances weaning process and may prevent or minimize the morbidity associated with long-term mechanical ventilation in a neonate with diaphragmatic paralysis.

Keywords
Neonate ; Diaphragmatic Paralysis ; Ventilation, Mechanical ; Lower Brachial Plexus Palsy

 
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Alternative site location: http://diglib.tums.ac.ir/pub/

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