Anaesthetic Management for Hiatal Hernia Repair in a Child with Bartter's Syndrome: A Case Report

Abstract

Bartter syndrome is a rare disorder characterized by reduced sodium chloride transport in the distal nephrons of the kidney. Its clinical features are renal salt wasting, hypokalemic metabolic alkalosis, elevated renin and aldosterone levels with normal or low blood pressure, polyuria, hypercalciuria and malnutrition. The pathophysiologic and biochemical changes in these patients should be kept in mind when considering anaesthetic management. This case report describes our management in a nineteen months old, 3.6 kg weight male child with Bartter's syndrome who underwent elective repair of hiatal hernia and gastrostomy.

Bartter Syndrome: A Systematic Review of Case Reports and Case Series

“…For the case reports ( Supplementary Figure S1 ), most of the included studies described the patient characteristics clearly, including the clinical condition on presentation, except for Sobash et al [ 47 ], Verma et al [ 50 ], and Yaqub et al [ 55 ]. The assessment methods and the results were clearly described in all of the reports, except for Alasfour et al [ 15 ] and Raza et al [ 45 ]. Most of the reports gave clear descriptions of the intervention or treatment procedures, along with the post-intervention clinical condition.…”

“…Under stressful situations, such as surgical procedures, the body fluid levels may rapidly change, and pose a significant challenge for both anesthesiologists and surgeons. Raza and colleagues [ 45 ] talk about such a case, emphasizing that the management of these patients requires a special focus on the maintenance of cardiovascular stability, control of the plasma potassium level, and the prevention of renal damage. This adds to the already established guidelines on the perioperative management of patients with inherited salt-wasting alkalosis.…”