Neonatal Care for Anesthesiologists

Abstract

In recent years, developments in obstetrics and neonatology have significantly improved the survival and quality life time of neonates. Therefore, anesthesiologists are more confronted with these patients due to surgical and non-surgical procedures. For a safe anesthetic approach and safe care, anesthesiologist must have necessary knowledge and equipment on the physiology of the newborn and should be better understand how immature organs respond to surgery and anesthetic. The purpose of this section is to present spot information that will allow clinicians and anesthesiologists to better understand the problems of neonatal patients and to perform safe care for these patients in the light of the physiologic characteristics of neonates. General principles of anesthetic management of neonatal patients are also reviewed and discussed.

Is Early Extubation Associated with Better Outcomes After Neonatal Congenital Heart Disease Surgery?

“…The higher rate of extubation failure among patients undergoing EE is not completely surprising. It is well known and described that neonates have several developmental physiological characteristics (immature hypoxic response, lower functional residual capacity, the central control of ventilation is not fully developed, higher baseline oxygen consumption per body mass, higher pulmonary vascular resistance, and slower metabolism of anesthetics and narcotics) that make them particularly vulnerable to experience extubation failure 17 following the physiologic stress of cardiovascular surgery under general anesthesia. Therefore, even after a "perfect surgery" and a good hemodynamic state, they may require a longer transition time following surgery to return to a safe state of unassisted spontaneous ventilation.…”