Patients with hyaline membrane disease (HMD) and bronchopulmonary dysplasia (BPD) can prove to be a challenge when it comes to proper ventilation and perfusion during surgical procedures.We present the case of a 3 month old male infant born at 27 weeks of gestation via caesarean section secondary to premature rupture of membranes which led to eventual neonatal sepsis that was treated appropriately.The patient presents complications related to the preterm birth such as HMD, BPD and an aggressive preterm retinopathy which required urgent vitrectomy to preserve visual function.The surgical procedure was done under total intravenous anesthesia (TIVA) due to the fact that the patient required high frequency ventilation which was not a setting readily available on anesthetic machines.In this case we highlight the importance of knowing the alternatives to inhaled anesthesia in patients with pulmonary disease in which administration of these agents can be erratic and unpredictable.Method: Case report with appropriate patient consent. RESUMENLos pacientes con enfermedad de membrana hialina (EMH) y displasia broncopulmonar (DBP) representan un desafío al momento de garantizar una adecuada ventilación y perfusión durante procedimientos quirúrgicos.Presen-