Continuous Noninvasive Hemodynamic Monitoring in an Infant With Tetra-Amelia

Abstract

Tetra-amelia syndrome is a congenital disorder associated with near or complete absence of all 4 limbs. Noninvasive hemodynamic monitoring may be difficult or impossible in such patients. We describe the use of a finger cuff blood pressure system for continuous noninvasive blood pressure monitoring in an infant with near-complete tetra-amelia undergoing laparoscopic gastrostomy tube placement. This case suggests the potential use of such a blood pressure monitoring system for other patients with comparable deformities.

Anesthetic management in an infant with tetra‐amelia syndrome with congenital maxillomandibular fusion: A case report

“…3 One study reported the application of a small finger cuff that was appropriate for the patient's extremity appendage. 4 In the present case, with a regular adhesive pulse oximetry sensor on the arm stump along with a forehead pulse oximetry sensor as a backup monitor, O 2 saturation was successfully monitored. Furthermore, there are other nonextremity placements of pulse oximeter probes, which may be able to be used in this such patients such as penis, tongue, or earlobe probes.…”

“…Earlier reports of patients with more extreme limb anomalies note that neither invasive nor noninvasive blood pressure monitoring could be performed because of the complete absence of all extremities 3 . One study reported the application of a small finger cuff that was appropriate for the patient's extremity appendage 4 . In the present case, with a regular adhesive pulse oximetry sensor on the arm stump along with a forehead pulse oximetry sensor as a backup monitor, O 2 saturation was successfully monitored.…”

“…Tetra‐amelia syndrome is an extremely rare anomaly. A few reports of pediatric tetra‐amelia syndrome patients who underwent surgery and anesthesia are available 4,6 …”

“…A few reports of pediatric tetra-amelia syndrome patients who underwent surgery and anesthesia are available. 4,6 IV access is necessary for providing rescue medication during emergencies, particularly in patients with suspected difficult airway. However, it seemed impossible in our case.…”