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Abstracts of the 7th World Congress on Pediatric Critical Care



Dewo, E.1

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Pediatric Critical Care Medicine: May 2014 - Volume 15 - Issue 4_suppl - p 37
doi: 10.1097/01.pcc.0000448870.62470.b8
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Background and aims: Managing patients with multiple congenital anomalies is always challenging. Prenatal diagnostic and postnatal care will carry abundant of problems among survivors, as improvement of intensive cares are being achieved in such settings.

Aims: To report an infant with multiple congenital anomalies, problems raised, and their management.

Methods: Case report

Results: A female infant born through cesarean section at 37-week gestation from 28-year-old-G 3 P 2 A 1 polihydramnion mother. She was edematous and cyanotic with inappropriate muscle tones, and was intubated for poor respiratory effort. Birth length, weight, and head circumference were less than standard for age. There was frontal bossing, orbital hypothelorism, bitemporal narrowing, a short and upturned nose, micrognathia, high palatal groove, downturned mouth, and a notched alveolar ridge. Her neck was short, the thorax was narrow. Holosystolic murmur was present. There were congenital flexion contracture in most joints, cletched hands and bilateral single transverse palmar crease. Extremities were tense and rigid with repetitive movements. Head ultrasound showed dilated septum pellucidum with no ventriculomegaly. Echocardiogram demonstrated TOF malformations. Abdominal ultrasound showed normal sized and echogenicity of liver and kidneys. The patient had a prolonged admission in the intensive care unit. On discharge, there were some medical concerns: feeding by the orogastric tube, risk of aspiration, respiratory tract blockage and infection, growth deficiency, psychomotor retardation, and worsened joint contractures, that had to be faced by family.

Conclusions: The need of solid multidisciplinary teamwork is mandatory to improve the quality of care for multiple congenital anomalies survivors.

©2014The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies