pCO2 in the immediate post-operative period. This is due to the CO2 insufflation that is
required for a minimally invasive approach. Slight hyperventilation (increased rate and
or TV) will rectify this within a few hours postoperatively
In some patients, reduction of the viscera from the chest to the abdomen may
cause abdominal compartment syndrome. These patients would require the viscera to
be temporarily placed in a silo or for a silastic patch to be placed on the fascia.
Abdominal closure can be achieved a few days later (usually after diuresis has been
achieved..
Post-Operative
On return from the OR, obtain a chest X-ray to check ETT placement. An ABG to
assess oxygenation and ventilation should be performed. Utilize the parameters.
Maintain appropriate oxygenation and ventilation, as outlined in the PPHN section. Note
that maintenance of ventricular filling pressures may result in increased fluid
requirements. Inotropic support may be needed to maintain appropriate mean arterial
blood pressure.
Potential Long Term Complications
Chronic lung disease
Feeding difficulties
Bowel obstruction
Recurrent herniation