High‐flow nasal cannula oxygen therapy for respiratory management after postoperative re‐intubation/re‐extubation in patients with trisomy 18 and trisomy 13: Two case reports

Abstract

Trisomy 18 and Trisomy 13 are associated with a variety of complications, including severe mental retardation and congenital heart disease, as well as extremely poor prognosis, which has generally precluded aggressive medical intervention in these patients. However, recent reports 1,2 show that various aggressive medical interventions such as cardiovascular surgery that can improve prognosis have led to increasing opportunities for these patients to undergo general anesthesia and intensive care. We report our experience with high-flow nasal canula (HFNC) oxygen therapy for respiratory management after postoperative re-intubation/re-extubation in two patients with trisomy 18 and trisomy 13.This article adheres to the Case Report guidelines. | CASE DESCRIPTION | Case 1The female patient was aged 2 years and 3 months with a height of 71.8 cm and a weight of 5.35 kg. She had trisomy 18 with mental retardation, interventricular septum defect, interatrial septum defect, patent ductus arteriosus, and pulmonary hypertension. No surgery was performed for these anomalies and only laparoscopic gastrostomy was performed this time.General anesthesia was induced slowly with sevoflurane and maintained with air, oxygen, sevoflurane, and remifentanil. Anticipating difficulty in intubation due to micrognathia, cervical spinal deformity, limited mandibular elevation, and leftward deviation of the head and