SEVERE BRONCHIAL HYPERREACTIVITY AS A SEQUEL TO CONGENITAL DIAPHRAGMATIC-HERNIA

Bronchial hyperreactivity may be a sequel to congenital diaphragmatic hernia (CDH). V/Q-mismatch in these patients may aggravate the conditi on. A case history is presented of a 20-month-old girl, who on the sec ond day of life survived surgery for a left CDH. Adrenaline intratrach eally via the nasotracheal tube was given to break a condition of refr actory bronchospasm and desaturation. In the case of refractory bronch ospasm and desaturation adrenaline may be helpful due to its alpha-rec eptor stimulation as this may inhibit bronchoconstriction, improve the V/Q mismatch and reduce pulmonary vascular resistance and mucosal swe lling.