ACE 5A

Question 1

What are treatment options for postoperative apnea of the neonate?

Answer 1

Tactile stimulation
Methylxanthine administration
nasal CPAP
correction of underlying metabolic disorders
PPV if above are ineffective

Question 2

Name three methylxanthines.

Answer 2

1) Caffeine citrate
2) theophylline
3) aminophylline

Question 3

Why is caffeine citrate preferred over theophylline and aminophylline for treatment of postoperative apnea of the newborn?

Answer 3

Theophylline has a decreased therapeutic window, less reliable absorption and a short half-life.

Aminophylline has increased cardiac side effects when compared with caffeine.

Question 4

What is bronchopulmonary dysplasia?

Answer 4

Chronic lung disease affecting premature infants who survived the acute phase of RDS and is characterized by the need for supplemental oxygen beyond four weeks of life.

Question 5

What are proposed mechanisms responsible for the development of BPD?

Answer 5

Prolonged periods of mechanical ventilation and high O2
excessive hydration
increased pulmonary blood flow
generalized inflammation

Question 6

What are the anesthetic implications for patients with BPD?

Answer 6

1) Superimposed acute respiratory infections
2) tracheal pathology (malacia, granuloma, stenosis)
3) increased airway reactivity
4) electrolyte disorders due to diuretic administration