Anesthesia for Neonatal Emergencies: General Principles
On a daily basis, pediatric anesthesiologists encounter challenges related to the size of their patients, “competition” for surface area to utilize monitoring equipment, as well as gaining access to the airway and blood vessels. All these challenges are further aggravated in premature infants and neonates, and yet again more aggravated in emergent situations.
Medical advances during the last few decades have resulted in improved survival of younger and smaller infants. At the same time this has created an increase of interventions in low/very low/extremely low birth weight infants who present with significant physiologic and anatomic immaturity as well as significant morbidity. These babies are more vulnerable to suffer complications that may result in significant challenges in the perioperative period.
This chapter will focus on some basic recommendations regarding neonatal physiology (glucose management, fluid management, transfusion management, neonatal shock), and the challenges awaiting the anesthesiologist in the perioperative phase, as well as strategies to optimize monitoring and therapy. The anesthetic management of specific cardiac and anatomic conditions (Examples: gastroschisis, TEF, CDH, Pyloric stenosis) are being covered in other chapters.
KeywordsAnesthesia Neonates Emergencies Temperature management Glucose management
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