Neonatal coomplications Flashcards
Which type of tracheoesophageal fistula (TEF) is the most common?
Type C
Blind pouch upper, esophagus connects with trachea lower
What is a key diagnostic indicator of TEF?
Maternal polyhydraminos
50-70% patients with TEF have another complication (VACTERL)
Verterbral defects
imperforated ANUS
Cardiac anomolies
Tef
Esophageal atresia
Renal dysplasia
Limb anomolies
Anesthesia management of TEF?
Head up, awake, spontaneous breathing (positive pressure distends the stomach). ETT below the fistula but ABOVE the carina
Type 2 pneumocytes begin making surfactant at _____ weeks, with peak production at ____ week
22-26
35-36
______ can be given to hasten lung maturity
betamethasone
L/S ratio over ____ suggests lung maturity, and under ____ could lead to respiratory distress syndrome
2, and under 2
Where do you place the pulse oximeter probe to obtain a pre-ductal spo2 value?
right arm
Where do you place the pulse oximeter probe to obtain a post-ductal spo2 value?
leg
Where is the most common site of herniation with congenital diaphragmatic hernia?
The foramen of Bochdalek (left upper abdomen)
Does omphalocele have a covering over the abdominal contents?
YES.. is midline
Does gastrochiosis have a covering over the abdominal contents?
NO..is off midline (right of umbilicus)
Whats worse, omphalocele or gastrochiosis?
gastrochiosis..more urgent and needs repair within 24 hours
With pyloric stenosis, the infant presents with _____, leading to _____ with _____ ______. _____. ____. ______
non-bilious projectile vomiting, dehydration, hyponatremia, hypokalemia, hypochloremia, metabolic alkolosis with compensatory respiratory acidosis
Pyloric stenosis is more/less common in males and typically presents in the first ____ of life.
More common in males, it presents in the first 2-12 weeks of life.
Is pyloric stenosis a medical or surgical emergency?
MEDICAL
DO NOT proceed to the OR until volume replacement has occurred (use 20ml/kg of 0.9% NS).
What is the best gas mixture for necrotizing enterocolitis?
50% fio2, 50% air
What are the risk factors for necrotizing enterocolitis?
prematurity (under 32 weeks) and low birth weight (under 1500 grams)
What is necrotizing enterocolitis the result of?
Early feeding
What can cause retinopathy or prematurity?
prematurity and hyperoxia (so keep spo2 between 89-94% until retinal maturity at 44 weeks). Monitoring preductal at RUE is best
Where do you place the pulse ox on a child with retinopathy of prematurity?
RUE (preductal)
Drugs that antagonize NDMA and/or stimulate GABA may cause ___
Apoptosis
So what has no effect on this? Precedex, opioids, xenon
Which congenital anomalies are associated with cardiac defects?
omphalocele and TEF
Which congenital defect is associated with pulmonary hypertension?
congenital diaphragmatic hernia
(abdominal contents enter the thoracic cavity)
