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Perioperative Metabolic Care of the Term and Preterm Infant

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Neonatal Anesthesia

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Abstract

This chapter discusses perioperative fluid and electrolyte therapy and enteral and parenteral nutrition for the full-term and premature neonate. The immaturity of the neonatal renal system and hypothalamic-pituitary-adrenal (HPA) axis and the postnatal development of these systems significantly affect fluid and electrolyte homoeostasis during infancy. Premature infants are deficient in endogenous nutrient stores as fetal accretion of calcium, phosphorus, carbohydrate, fat and protein predominantly occurs during the third trimester. Consequently, extremely low birth weight (ELBW) infants (<1,000 g) and infants with intrauterine growth restriction (IUGR) are at greater risk for hypoglycaemia during early postnatal life than are full-term neonates. Metabolic stress associated with sepsis, cardiorespiratory disease and surgery may further imbalance glucose homoeostasis leading to large swings in glucose.

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Authors and Affiliations

  1. Department of Anaesthesia and Pain Management, Royal Children’s Hospital, Flemington Road, Parkville, VIC, 3052, Australia

    Geoff Frawley

  2. Department of Anesthesia, Montreal Children’s Hospital, 2300 Tupper Street, C1115, Montreal, QC, Canada, H3H 1P3

    Pablo Ingelmo

  3. Division of Neonatology, Women and Children’s Hospital of Buffalo, 219 Bryant Street, Buffalo, NY, 14222, USA

    Satyan Lakshminrusimha MD

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  1. Geoff Frawley
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  2. Pablo Ingelmo
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Correspondence to Pablo Ingelmo .

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  1. Department of Anesthesia, Women & Children's Hospital of Buffalo, Buffalo, New York, USA

    Jerrold Lerman

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Frawley, G., Ingelmo, P., Lakshminrusimha, S. (2015). Perioperative Metabolic Care of the Term and Preterm Infant. In: Lerman, J. (eds) Neonatal Anesthesia. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6041-2_8

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