Manual of Neonatal Surgical Intensive Care

 

Using a quick-reference, bulleted format, Manual of Neonatal Surgical Intensive Care, Fourth Edition, edited by Drs. Anne R. Hansen and Mark Puder, provides complete coverage of this challenging and multifaceted field in a concise, easy-to-digest manner. Written for both medical and surgical clinicians, this practical manual is a collaboration of the medical and surgical staff at Boston Children’s Hospital, Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, and other institutions that addresses the perioperative management of newborns with surgical conditions.

 

Table of Contents:

1. General Considerations

1.1: Medical Considerations

DEFINITIONS

CLASSIFICATION OF GESTATIONAL AGE AND SIZE AT BIRTH

HIGH-RISK INFANTS

Intrauterine Growth Restriction/Small for Gestational Age

Large for Gestational Age

Prematurity

FLUID, ELECTROLYTE, AND NUTRITIONAL MANAGEMENT OF SICK NEWBORNS

Intravenous Nutrition and Hydration

Enteral Nutrition and Hydration

1.2: Parenteral Nutrition for the Surgical Infant

OVERVIEW

INDICATIONS

FLUID NEEDS

VENOUS ACCESS

ENERGY NEEDS

COMPONENTS OF PN

MACRONUTRIENTS

CARBOHYDRATES

FAT

LIPID CALCULATIONS

PROTEIN

VITAMIN AND MICRONUTRIENTS

Micronutrient Requirements

Trace Elements

Vitamins

Other Additives

SPECIAL SITUATIONS

Starter PN

MONITORING

WEANING/DISCONTINUING PN

METABOLIC COMPLICATIONS

1.3: Surgical Considerations

STABILIZATION AND TRANSPORT OF THE INFANT FOR SURGERY

Referring Center

Accepting Center

Preoperative Preparation

DISEASES REQUIRING SURGERY IN THE NEWBORN PERIOD

Tracheoesophageal Fistula and Esophageal Atresia

Intestinal Obstruction

Intestinal Atresia

Hirschsprung Disease

Meconium Ileus

Midgut Malrotation and Volvulus

Omphalocele and Gastroschisis

Necrotizing Enterocolitis

Congenital Diaphragmatic Hernia

GENERAL PERIOPERATIVE FLUID MANAGEMENT

NPO Orders

IV Fluids

Bowel Preparation for GI Surgical Procedures

Deficit Therapy

Body Fluid Compositions

Blood Replacement

1.4: Respiratory Management

VENTILATION

OXYGENATION

SELECTING THE MODE OF RESPIRATORY SUPPORT

Nasal Cannula Oxygen

Continuous Positive Airway Pressure

Nasal Intermittent Positive Pressure Ventilation

Bilevel Positive Airway Pressure

Conventional Mechanical Ventilation

High-Frequency Ventilation

SUPPLEMENTAL THERAPIES FOR ASSOCIATED RESPIRATORY CONDITIONS

Fetal Lung Maturity

Surfactant Deficiency

Persistent Pulmonary Hypertension of the Newborn

Apnea and Periodic Breathing

Evolving BPD

Airway Edema

Pain, Anxiety, and Agitation

ACKNOWLEDGMENT

1.5: Differential Diagnoses According to Presenting Symptoms

RESPIRATORY DISTRESS

SCAPHOID ABDOMEN

EXCESSIVE MUCUS AND SALIVATION

ABDOMINAL DISTENTION

VOMITING

FAILURE TO PASS MECONIUM

FAILURE TO DEVELOP TRANSITIONAL STOOLS

HEMATEMESIS OR HEMATOCHEZIA

ABDOMINAL MASSES

BIRTH TRAUMA

1.6: Vascular Access

EPIDEMIOLOGY

PHYSIOLOGY

STERILE TECHNIQUE

PERIPHERAL VENOUS ACCESS

Location

Technique

Complications

CENTRAL VENOUS ACCESS

Sizes

Indications

Tip Position

Location

Catheter Types

At Time of Catheter Placement

Catheter Care

Complications

Treatment

Consideration of Catheter Removal

Indications for Catheter Removal

Central Line Removal

UMBILICAL ACCESS

Background

Indications

Contraindications

Insertion Technique

Complications

Removal Technique

PERIPHERAL ARTERIAL ACCESS

Indications

Location

Technique

Complications

INTRAOSSEOUS ACCESS

Background

Indications

Location

Technique

Complications

2. The Fetus

PRENATAL DIAGNOSIS

Early Screening—Biomarkers

Early Screening—Cell-Free DNA

Chorionic Villus Sampling

Amniocentesis

Fetal Blood Sampling

Diagnostic Testing Approaches

Preimplantation Diagnosis

Imaging

FETAL THERAPY

Prenatal Medical Therapies

Prenatal Fetal Surgeries

Recommendations

Surgical Approaches

SPECIFIC FETAL DISORDERS

Complicated Monochorionic Pregnancies

Amniotic Band Syndrome

Chorioangioma

Fetal Congenital Lung Lesions

Congenital Diaphragmatic Hernia

Sacrococcygeal Teratoma

Lower Urinary Tract Obstruction

Open Neural Tube Defects

Intrauterine Cardiac Interventions

3. Otolaryngology, Head and Neck Surgery

3.1: Laryngeal and Tracheal Anomalies

EMBRYOLOGY OF THE LARYNX AND TRACHEA

MORPHOLOGY OF THE NEONATAL LARYNX

CONGENITAL ANOMALIES OF THE LARYNX

Laryngomalacia

Laryngeal Web

Laryngotracheal Cleft

Unilateral Vocal Fold Palsy

Bilateral Vocal Fold Palsy

Subglottic Stenosis

Tracheomalacia

Tracheostomy

REASONS FOR FAILED DECANNULATION

3.2: Nasal Anomalies

CHOANAL ATRESIA AND STENOSIS

Definition

Embryology

Incidence

Clinical Features

Prenatal Diagnosis

Postnatal Diagnosis

Differential Diagnosis

Preoperative Management

Anesthetic and Perioperative Management

Surgical Management

Postoperative Management

Surgical Complications

Outcomes

CONGENITAL PYRIFORM APERTURE STENOSIS

Definition

Embryology

Incidence

Clinical Features

Prenatal Diagnosis

Postnatal Diagnosis

Differential Diagnosis

Management

Anesthetic and Perioperative Management

Surgical Management

Postoperative Management

Surgical Complications

Outcomes

4. Cleft Lip/Palate and Robin Sequence

EMBRYOLOGY

EPIDEMIOLOGY

PRENATAL DIAGNOSIS

POSTNATAL PRESENTATION

ASSOCIATED ANOMALIES

Robin Sequence

PREOPERATIVE MANAGEMENT

Cleft Lip/Palate

Robin Sequence

ANESTHETIC MANAGEMENT

SURGICAL MANAGEMENT

Cleft Lip/Palate

Robin Sequence

POSTOPERATIVE MANAGEMENT

Cleft Lip/Palate

Robin Sequence

COMPLICATIONS/OUTCOME

Cleft Lip

Cleft Palate

Robin Sequence

5. Cardiovascular Disorders

5.1: Patent Ductus Arteriosus

EMBRYOLOGY

INCIDENCE

MECHANISM OF DUCTAL CLOSURE

CLINICAL PRESENTATION IN THE NEONATAL PERIOD

DIAGNOSIS AND DEFINING A HEMODYNAMICALLY SIGNIFICANT PDA

DIFFERENTIAL DIAGNOSIS

PREOPERATIVE MANAGEMENT

Conservative Approach

Pharmacologic

Definitive

INDICATIONS FOR DEFINITIVE CLOSURE

ANESTHETIC MANAGEMENT

Transcatheter Device Closure

Surgical Ligation

CATHETERIZATION PROCEDURE

SURGICAL MANAGEMENT

POSTOPERATIVE MANAGEMENT

Transcatheter Closure

Surgical Ligation

COMPLICATIONS AND OUTCOME

Postclosure Cardiac Syndrome

Additional Complications

5.2: Vascular Rings, Pulmonary Artery Slings, and Other Tracheal Anomalies

EMBRYOLOGY

DEFINITION

CLASSIFICATION

Complete

Incomplete

POSTNATAL PRESENTATION

DIAGNOSIS

DIFFERENTIAL DIAGNOSIS

PREOPERATIVE MANAGEMENT

ANESTHETIC MANAGEMENT

SURGICAL MANAGEMENT

POSTOPERATIVE MANAGEMENT

COMPLICATIONS AND OUTCOME

PULMONARY ARTERY SLINGS

Surgery

5.3: Vascular Anomalies

VASCULAR TUMORS

Infantile Hemangioma

Congenital Hemangioma

Kaposiform Hemangioendothelioma

Pyogenic Granuloma

VASCULAR MALFORMATIONS

Capillary Malformation

Lymphatic Malformation

Venous Malformation

Arteriovenous Malformation

6. Respiratory Disorders

6.1: Esophageal Atresia and Tracheoesophageal Fistula

EMBRYOLOGY

INCIDENCE

PRENATAL DIAGNOSIS

POSTNATAL CLINICAL PRESENTATION

Diagnosis

DIFFERENTIAL DIAGNOSIS

PREOPERATIVE MANAGEMENT

ANESTHETIC MANAGEMENT

SURGICAL MANAGEMENT

Isolated EA (Without TEF)

TEF (Without EA): H-Type Fistula

POSTOPERATIVE MANAGEMENT

COMPLICATIONS AND OUTCOMES

6.2: Congenital Diaphragmatic Hernia and Diaphragmatic Eventration

EMBRYOLOGY

CLASSIFICATION

EPIDEMIOLOGY

PRENATAL DIAGNOSIS

POSTNATAL CLINICAL PRESENTATION

DIFFERENTIAL DIAGNOSIS

PREOPERATIVE MANAGEMENT

Delivery Room Resuscitation

INTERFACILITY TRANSPORT

Team Composition

Pretransport Stabilization

Mode of Transport

PREOPERATIVE ICU MANAGEMENT

Admission Care/Monitoring

Respiratory Care

Cardiovascular Support

Fluids, Electrolytes, and Nutrition

Pain Management and Sedation/Neurologic Considerations

Infectious Disease

Hematology

SURGICAL MANAGEMENT

Timing of Operation

Surgical Techniques

Surgical Classification

POSTOPERATIVE MANAGEMENT

Respiratory Care

Cardiovascular Support

Fluids, Electrolytes, and Nutrition

Pain Management and Sedation/Neurologic Considerations

Infectious Disease

Hematology

COMPLICATIONS/OUTCOME

Mortality

Morbidity

DIAPHRAGMATIC EVENTRATION

Definition

Etiology

Symptoms

Diagnosis

Treatment

6.3: Pneumothorax and Air Leak

DEFINITIONS AND INCIDENCE

ETIOLOGY

PRESENTATION

DIAGNOSIS

MANAGEMENT

Thoracentesis

Chest Tube Placement

COMPLICATIONS

PNEUMOMEDIASTINUM

PNEUMOPERICARDIUM

Diagnosis

Management

ACKNOWLEDGMENT

6.4: Chylothorax

DEVELOPMENT OF THE LYMPHATIC SYSTEM

ETIOLOGY

PRENATAL DIAGNOSIS AND MANAGEMENT

POSTNATAL PRESENTATION

POSTNATAL DIAGNOSIS

MEDICAL MANAGEMENT

Cardiopulmonary Support

Chest Drainage

Tube Removal

Fluids, Electrolytes, and Nutrition

Immunologic/Hematologic

SURGICAL MANAGEMENT

COMPLICATIONS

PROGNOSIS

6.5: Thoracic Mass Lesions

CONGENITAL PULMONARY AIRWAY MALFORMATION

Embryology

Epidemiology

Prenatal Diagnosis

Postnatal Presentation

Differential Diagnosis

Surgical Management

Complications

BRONCHOPULMONARY SEQUESTRATION

Embryology

Epidemiology

Prenatal Diagnosis

Postnatal Presentation and Diagnosis

Differential Diagnosis

Surgical Management

Complications

BRONCHOGENIC CYST

Embryology

Epidemiology

Prenatal Diagnosis

Postnatal Presentation

Differential Diagnosis

Surgical Management

Complications

Postoperative Management

CONGENITAL LOBAR EMPHYSEMA

Embryology

Epidemiology

Prenatal Diagnosis

Postnatal Presentation

Postnatal Diagnosis

Differential Diagnosis

Surgical Management

Complications

Postoperative Management

6.6: Extracorporeal Life Support (ECLS)

CRITERIA

PRE-ECMO EVALUATION

INDICATIONS

CONTRAINDICATIONS

Absolute Contraindications

Relative Contraindications

MODES

Venovenous

Venoarterial

CANNULATION

CIRCUIT MANAGEMENT

Priming the Circuit

Clear Prime

Initiation of ECLS

Maintenance

PATIENT MANAGEMENT

Cardiovascular

Respiratory

Neurologic

Fluid Management

Renal

Nutrition

Infectious Disease

Hematology

WEANING OFF ECLS

Weaning on VA ECLS

Weaning on VV ECLS

COMPLICATIONS

Neurologic Complications

Hemorrhagic Complications

Renal Complications

Infectious Complications

Cardiovascular Complications

OUTCOMES

7. Gastrointestinal Disorders

7.1: Gastroschisis

EMBRYOLOGY

Normal Gastrointestinal Formation and Rotation

ETIOLOGY

INCIDENCE

PRENATAL DIAGNOSIS AND TREATMENT

Preferred Route of Delivery

POSTNATAL PRESENTATION

POSTNATAL DIAGNOSIS

Associated Defects

DIFFERENTIAL DIAGNOSIS

PREOPERATIVE MANAGEMENT

SURGICAL MANAGEMENT

POSTOPERATIVE MANAGEMENT

Nutritional Support

Control of Pain

Infection Risks

COMPLICATIONS AND OUTCOME

7.2: Omphalocele

EMBRYOLOGY

INCIDENCE

PRENATAL DIAGNOSIS AND TREATMENT

POSTNATAL PRESENTATION

POSTNATAL DIAGNOSIS

Associated Anomalies

ASSOCIATED SYNDROMES

DIFFERENTIAL DIAGNOSIS

PREOPERATIVE MANAGEMENT

SURGICAL MANAGEMENT

POSTOPERATIVE MANAGEMENT

COMPLICATIONS AND OUTCOME

7.3: Necrotizing Enterocolitis

ANATOMY

EPIDEMIOLOGY

PATHOGENESIS

Prematurity

Microbial Dysbiosis

Enteral Alimentation

Other Risk Factors

PREVENTION

Potential Preventive Strategies

DIAGNOSIS

Physical Examination

Blood Tests

Stool Tests

Imaging Studies

Surgical Diagnosis

Staging

DIFFERENTIAL DIAGNOSIS

MANAGEMENT

Preoperative Management

Indications for Surgery

ANESTHETIC MANAGEMENT

SURGICAL MANAGEMENT

POSTOPERATIVE MANAGEMENT

Ongoing Management

General Considerations

COMPLICATIONS

Strictures

Short Bowel Syndrome

Long-Term Dependence on Parenteral Nutrition

RECURRENCE

FOLLOW-UP SURGICAL PROCEDURES

TRANSPLANTATION

OUTCOMES

7.4: Obstruction

EMBRYOLOGY

Week 4

Weeks 6 and 7

INCIDENCE

Proximal Obstruction

Small Bowel Obstruction

Large Bowel Obstruction

PRENATAL DIAGNOSIS AND MANAGEMENT

Esophageal Atresia

Pyloric Atresia

Duodenal Atresia and Stenosis

Meconium Ileus

GENERAL APPROACH TO THE INFANT WITH A BOWEL OBSTRUCTION

History

Physical Examination

Laboratory Studies

Radiographic Studies

Management

POSTNATAL PRESENTATION AND MANAGEMENT

Antral and Pyloric Webs

Pyloric or Antral Atresia

Pyloric Stenosis

Gastric Volvulus

Duodenal Atresia and Web

Annular Pancreas

Malrotation and Midgut Volvulus

Intussusception

Intestinal Atresia

GI Duplications

Hernia

Omphalomesenteric Duct Remnant

Internal Hernia

Meconium Ileus

Meconium Plug Syndrome

Colonic Atresia

Hirschsprung Disease

Imperforate Anus

Postoperative Adhesions

Functional Obstructions

7.5: Gastrointestinal Bleeding

DEFINITIONS

GENERAL PRESENTATION AND MANAGEMENT

HISTORY

DIAGNOSIS AND MANAGEMENT

DIFFERENTIAL DIAGNOSIS

UGI Bleeding

LGI Bleeding

UGI or LGI Bleeding

7.6: Intestinal Failure and Short Bowel Syndrome

EPIDEMIOLOGY

FACTORS AFFECTING PROGNOSIS

Length of Small Bowel Resected

Portion of Small Bowel Resected

Presence or Absence of ICV

Adaptive and Functional Capacity of the Remaining Small Bowel

Intestinal Failure–Associated Liver Disease

Small Bowel Bacterial Overgrowth

NUTRITION THERAPY IN SBS

Fluid, Electrolytes and PN

Enteral Feedings

How to Feed

EXTRAINTESTINAL COMPLICATIONS OF SBS

MULTIDISCIPLINARY CARE

SURGICAL MANAGEMENT OF SBS

Initial Operative Strategy

Established SBS

Central Venous Access

Bowel Rehabilitation

Transplantation

SUMMARY

7.7: Inguinal Hernia

ANATOMY

EPIDEMIOLOGY

Pathogenesis

DIAGNOSIS

Physical Examination

Radiographic Studies

DIFFERENTIAL DIAGNOSIS

Testicular Torsion

Lymphadenitis

Hydrocele

MANAGEMENT OF INCARCERATED HERNIAS

Reduction Techniques

Postreduction Management

The Unreducible Hernia

NONINCARCERATED HERNIAS IN PREMATURE INFANTS

POSTOPERATIVE MANAGEMENT

BILATERAL VERSUS UNILATERAL REPAIR

OPEN REPAIR

LAPAROSCOPIC REPAIR

COMPLICATIONS

Recurrence

Scrotal Swelling

Testicular Compromise, Cyanosis, or Atrophy

Spermatic Cord Injury

Intestinal Injury

Iatrogenic Undescended Testes

7.8: Umbilical Hernia

EMBRYOLOGY

Formation of the Umbilical Ring

INCIDENCE

PRENATAL DIAGNOSIS

POSTNATAL PRESENTATION

POSTNATAL DIAGNOSIS

DIFFERENTIAL DIAGNOSIS

PREOPERATIVE MANAGEMENT

ANESTHETIC MANAGEMENT

SURGICAL MANAGEMENT

POSTOPERATIVE MANAGEMENT

COMPLICATIONS AND OUTCOME

7.9: Feeding Tubes

REASONS FOR PLACING A FEEDING TUBE IN AN INFANT

CHOOSING A FEEDING TUBE

ILLNESSES AND CONDITIONS IN WHICH FEEDING TUBES ARE PLACED

Oropharyngeal Dysphagia

Gastrointestinal Malformations and Motility Disturbances

Other Chronic Illnesses and Conditions

Behavioral and Functional Disorders

EVALUATION OF AN INFANT WITH A FEEDING OR NUTRITIONAL DISORDER

Chart Review

History From Caretaker

Physical Examination

Laboratory Studies

Nutritional Evaluation

Chest Radiograph

Barium Swallow

Fiberoptic Endoscopic Evaluation of Swallow

Abdominal Ultrasound

Esophagogastroduodenoscopy

PLACEMENT OF A G TUBE

Surgical Techniques

Preoperative Considerations for the Infant Undergoing Gastrostomy Placement

Relative Contraindications to G Tube Placement

Absolute Contraindications to G Tube Placement

Laparoscopic G Tube Placement

PEG Using the Pull (Gauderer) Technique

The Stamm (Open) G Tube Procedure

Placement by Interventional Radiology

POSTOPERATIVE MANAGEMENT

COMPLICATIONS OF G TUBE PLACEMENT

CARE AND MANAGEMENT

Feeding Regimen

Skin Care of Gastrostomy

Tube Replacement

GE Reflux

Transition From Hospital to Home Enteral Tube Feedings

Transition to Oral Feedings

7.10: Gastroesophageal Reflux

PATHOPHYSIOLOGY

INCIDENCE

SIGNS AND SYMPTOMS

DIAGNOSTIC MODALITIES

CONSERVATIVE MANAGEMENT

MEDICAL MANAGEMENT

SURGICAL MANAGEMENT

Special Considerations

Operations

Complications of Antireflux Surgical Procedures

7.11: Ostomy Diversions and Management

INDICATIONS FOR STOMA CREATION

SELECTION OF STOMA SITE

PREPARATION OF THE BOWEL

TYPES OF GASTROINTESTINAL DIVERSIONS

End Stoma

Mucous Fistula

Hartmann Pouch

Loop Stoma

Double-Barrel Stoma

Special Stoma Considerations in NEC

TYPES OF INCONTINENT URINARY TRACT DIVERSIONS

Ureterostomy

Vesicostomy

POSTOPERATIVE MANAGEMENT

Stoma Assessment

STOMA POUCHING CONSIDERATIONS

Premature Infants

Pouch Application Instructions

Pouch Emptying

POUCHING CHALLENGES

Peristomal Skin Compromise

Stomal Complications

SURGICAL COMPLICATIONS POST STOMA CREATION PROCEDURE

Incisional Dehiscence

Anastomotic Leak

Bowel Obstruction

Hernia

OSTOMY CARE EDUCATION

ACKNOWLEDGMENT

8. Genitourinary Disorder

8.1: Obstruction of the Urinary Tract, Including Hydronephrosis

RENAL EMBRYOLOGY

DIAGNOSIS

Antenatal Hydronephrosis: Diagnosis and Classification Systems

Postnatal Evaluation of Urinary Tract Obstruction

DIFFERENTIAL DIAGNOSIS

MANAGEMENT

Prenatal Treatment of Urinary Tract Obstruction

Postnatal Consequences of Prenatal Obstruction

Antibiotic Prophylaxis for ANH and Obstructing Uropathies

Postnatal Management

Anesthetic Management

Surgical Management

POSTOPERATIVE MANAGEMENT

8.2: Renal Venous Thrombosis in Neonates

MECHANISMS

INCIDENCE

PRENATAL DIAGNOSIS

POSTNATAL PRESENTATION

POSTNATAL DIAGNOSIS

DIFFERENTIAL DIAGNOSIS

MEDICAL MANAGEMENT

SURGICAL MANAGEMENT

ANESTHETIC MANAGEMENT

POSTOPERATIVE MANAGEMENT

COMPLICATIONS/OUTCOME

8.3: Cystic Kidney Disease

ANATOMY

EPIDEMIOLOGY

PATHOGENESIS

DIAGNOSIS

Physical Examination

Radiographic Studies

DIFFERENTIAL DIAGNOSIS

MANAGEMENT

COMPLICATIONS AND OUTCOMES

8.4: Bladder Exstrophy

ANATOMY

EPIDEMIOLOGY

PATHOGENESIS

PRENATAL DIAGNOSIS/TREATMENT

POSTNATAL PRESENTATION

POSTNATAL DIAGNOSIS

DIFFERENTIAL DIAGNOSIS

PREOPERATIVE MANAGEMENT

SURGICAL MANAGEMENT

POSTOPERATIVE MANAGEMENT

COMPLICATIONS/OUTCOME

8.5: Cloacal Exstrophy

EMBRYOLOGY/PATHOGENESIS

Anatomy

INCIDENCE

PRENATAL DIAGNOSIS

POSTNATAL DIAGNOSIS

DIFFERENTIAL DIAGNOSIS

PREOPERATIVE MANAGEMENT

ANESTHETIC MANAGEMENT

SURGICAL MANAGEMENT

POSTOPERATIVE MANAGEMENT

COMPLICATIONS

OUTCOMES

8.6: Urolithiasis in Neonates

EPIDEMIOLOGY

PATHOGENESIS

Acquired

Metabolic

PRENATAL DIAGNOSIS

POSTNATAL PRESENTATION

POSTNATAL DIAGNOSIS

DIFFERENTIAL DIAGNOSIS

MEDICAL MANAGEMENT

SURGICAL MANAGEMENT

POSTOPERATIVE MANAGEMENT

COMPLICATIONS

OUTCOME

8.7: Dialysis/Catheters

EPIDEMIOLOGY

PATHOGENESIS

Neonatal AKI

Premature Infants

DIAGNOSIS

History and Physical Exam

Laboratory Studies

Imaging

MANAGEMENT

Indications

Preoperative Management

Anesthetic Management

Hemodialysis and Continuous Renal Replacement

Peritoneal Dialysis

POSTOPERATIVE MANAGEMENT (AFTER ACCESS PLACEMENT)

Hemodialysis

Peritoneal Dialysis

COMPLICATIONS

8.8: Neurogenic Bladder Dysfunction in the Newborn

EMBRYOLOGY AND ANATOMY

INCIDENCE

PRENATAL DIAGNOSIS

POSTNATAL DIAGNOSIS

ASSOCIATED ANOMALIES

DIFFERENTIAL DIAGNOSIS

PREOPERATIVE MANAGEMENT

SURGICAL MANAGEMENT

COMPLICATIONS

POSTOPERATIVE MANAGEMENT

OUTCOMES

8.9: Testicular Torsion

ANATOMY

EPIDEMIOLOGY

PATHOGENESIS

DIAGNOSIS

Physical Examination

Radiographic Studies

DIFFERENTIAL DIAGNOSIS

PREOPERATIVE MANAGEMENT

ANESTHETIC MANAGEMENT

SURGICAL MANAGEMENT

PREMATURE INFANTS

POSTOPERATIVE MANAGEMENT

COMPLICATIONS

8.10: Circumcision

EMBRYOLOGY

INCIDENCE

POSTNATAL PRESENTATION

CONTRAINDICATIONS TO NEONATAL CIRCUMCISION

PREOPERATIVE CONSIDERATIONS

PREOPERATIVE MANAGEMENT

PERINATAL SURGICAL MANAGEMENT

Caution

POSTOPERATIVE MANAGEMENT

COMPLICATIONS

Early/Immediate Complications

Late Complications

ACKNOWLEDGMENT

8.11: Hypospadias

ANATOMY

EPIDEMIOLOGY

PATHOGENESIS

DIAGNOSIS

Radiologic Assessment

DIFFERENTIAL DIAGNOSIS

MANAGEMENT

CONSIDERATIONS IN PREMATURE INFANTS

PERIOPERATIVE MANAGEMENT AND SURGICAL COMPLICATIONS

ANESTHETIC MANAGEMENT

POSTOPERATIVE MANAGEMENT

Potential Postoperative Complications

8.12: Undescended Testicles

EMBRYOLOGY AND ANATOMY

INCIDENCE

PRENATAL DIAGNOSIS

POSTNATAL DIAGNOSIS

ASSOCIATED ANOMALIES

DIFFERENTIAL DIAGNOSIS

PREOPERATIVE MANAGEMENT

ANESTHETIC MANAGEMENT

SURGICAL MANAGEMENT

COMPLICATIONS

POSTOPERATIVE MANAGEMENT

OUTCOMES

8.13: Differences of Sex Development

TERMINOLOGY

INITIAL APPROACH

EMBRYOLOGY

INCIDENCE

PRENATAL DIAGNOSIS

POSTNATAL DIAGNOSIS

DIFFERENTIAL DIAGNOSIS

ASSESSMENT

MANAGEMENT

SURGICAL MANAGEMENT

PREOPERATIVE ISSUES, ANESTHETIC RISKS, AND POSTOP MANAGEMENT

SURGICAL COMPLICATIONS

OUTCOMES

9. Neurologic Disorders

9.1: Neonatal Hydrocephalus

EMBRYOLOGY

INCIDENCE

PRENATAL DIAGNOSIS

POSTNATAL PRESENTATION

POSTNATAL DIAGNOSIS

DIFFERENTIAL DIAGNOSIS

Hydrocephalus Requiring Treatment

Stable Ventriculomegaly: Caused by Atrophy or Brain Malformation

PREOPERATIVE MANAGEMENT

Supportive Measures

Further Diagnostic Studies

Preterm Infants

PLACEMENT OF VP SHUNT

ETV and CPC

POSTOPERATIVE MANAGEMENT

COMPLICATIONS

Surgical Complications

Medical Complications

OUTCOME

9.2: Myelomeningocele

EMBRYOLOGY/DEFINITION

INCIDENCE AND SURVIVAL

PRENATAL DIAGNOSIS AND PREVENTIVE TREATMENT

POSTNATAL CLINICAL PRESENTATION

ETIOLOGY

PREOPERATIVE MANAGEMENT

ANESTHETIC MANAGEMENT

SURGICAL MANAGEMENT

Postnatal

Prenatal

POSTOPERATIVE MANAGEMENT

COMPLICATIONS/OUTCOMES

9.3: Vein of Galen Malformation

EMBRYOLOGY

INCIDENCE

PRENATAL DIAGNOSIS

POSTNATAL DIAGNOSIS

ASSOCIATED ANOMALIES

DIFFERENTIAL DIAGNOSIS

PREOPERATIVE MANAGEMENT

ANESTHETIC MANAGEMENT

SURGICAL MANAGEMENT

COMPLICATIONS

POSTOPERATIVE MANAGEMENT

OUTCOMES

10. Retinopathy of Prematurity

EMBRYOLOGY

INCIDENCE

PRENATAL DIAGNOSIS

POSTNATAL DIAGNOSIS

DIFFERENTIAL DIAGNOSIS

PREOPERATIVE MANAGEMENT/ANESTHESIA

SURGICAL MANAGEMENT

COMPLICATIONS

POSTOPERATIVE MANAGEMENT

OUTCOMES

11. Intravenous Extravasation Injuries

MECHANISM OF DAMAGE

PREVENTION

PHYSICAL EXAMINATION

INITIAL MANAGEMENT

TREATMENT OF WOUND COMPLICATIONS

MORE AGGRESSIVE INTERVENTIONS

12. Orthopedic Considerations in the Surgical Neonate

GENERAL CONSIDERATIONS

SKELETAL BIRTH TRAUMA—FRACTURES AND DISLOCATIONS

General Considerations

Embryology

Incidence and Etiology

Humerus

Femur

Spine

Prenatal Diagnosis and Treatment

Postnatal Diagnosis

Humerus

Femur

Spine

Management

Humerus

Femur

Spine

Complications and Outcomes

Humerus

BRACHIAL PLEXUS INJURY

Embryology

Incidence and Etiology

Prenatal Diagnosis and Treatment

Postnatal Diagnosis and Treatment

Management

Complications and Outcomes

THE THREATENED LIMB

General Considerations

Embryology

Incidence and Etiology

Prenatal Diagnosis and Treatment

Postnatal Diagnosis

Management

Complications and Outcomes

MUSCULOSKELETAL INFECTION

General Consideration

Embryology

Incidence and Etiology

Osteomyelitis

Vertebral Osteomyelitis

Prenatal Diagnosis and Treatment

Postnatal Presentation and Diagnosis

Management

Septic Arthritis

Osteomyelitis

Vertebral Osteomyelitis/Diskitis

Complications and Outcomes

ORTHOPEDIC CONGENITAL DEFORMITIES

“Congenital” Muscular Torticollis (Wryneck)

Prenatal Diagnosis and Treatment

Postnatal Diagnosis

Management

Complications and Outcomes

CONGENITAL SPINE PROBLEMS

Embryology

Incidence and Etiology

Congenital Scoliosis, Kyphosis

Klippel-Feil Syndrome

Prenatal Diagnosis and Treatment

Postnatal Diagnosis

Spinal Dysraphism

Congenital Scoliosis/Kyphosis

Klippel-Feil Syndrome

Management

Congenital Scoliosis/Kyphosis

Klippel-Feil Syndrome

Complications and Outcomes

CONGENITAL UPPER EXTREMITY PROBLEMS

Embryology

Incidence and Etiology

Congenital Amputations

Constriction Bands

Phocomelia

Radial Clubhand

Central Ray (Metacarpal) Deficiency

Syndactyly

Thumb Hypoplasia

Thumb Duplication

Postaxial Polydactyly

Central Polydactyly

Overgrowth/Macrodactyly

Prenatal Diagnosis and Treatment

Postnatal Diagnosis

Congenital Amputations

Constriction Bands

Phocomelia

Radial Clubhand

Central Ray Deficiency

Syndactyly

Thumb Hypoplasia

Thumb Duplication

Postaxial Polydactyly

Central Polydactyly

Overgrowth/Macrodactyly

Management

Congenital Amputations

Constriction Bands

Phocomelia

Radial Clubhand

Central Ray Deficiency

Syndactyly

Thumb Hypoplasia

Thumb Duplication

Postaxial Polydactyly

Central Polydactyly

Macrodactyly

Complications and Outcomes

CONGENITAL LOWER EXTREMITY PROBLEMS

Embryology

Incidence and Etiology

Proximal Femoral Focal Deficiency (Congenital Short Femur)

Posteromedial Bowing of the Tibia

Fibular Hemimelia/Deficiency

Tibial Hemimelia/Hypoplasia

Congenital Knee Dislocation

Talipes Equinovarus

Congenital Vertical Talus

Prenatal Diagnosis and Treatment

Postnatal Diagnosis

Proximal Femoral Focal Deficiency (Congenital Short Femur)

Anterolateral Bowing of the Tibia (Congenital Pseudarthrosis)

Fibular Hemimelia

Tibial Hemimelia

Congenital Knee Dislocation

Talipes Equinovarus

Pes Calcaneovalgus

Congenital Vertical Talus

Management

Proximal Femoral Focal Deficiency

Posteromedial Bowing of the Tibia

Anterolateral Bowing of the Tibia (Congenital Pseudarthrosis)

Fibular Hemimelia

Tibial Hemimelia

Congenital Knee Dislocation

Talipes Equinovarus

Pes Calcaneovalgus

Congenital Vertical Talus

Complications and Outcomes

Proximal Femoral Focal Deficiency

Posteromedial Bowing of the Tibia

Anterolateral Bowing of the Tibia (Congenital Pseudarthrosis)

Fibular Hemimelia

Tibial Hemimelia

Congenital Knee Dislocation

Talipes Equinovarus

Pes Calcaneovalgus

Congenital Vertical Talus

13. Genetic Considerations

DIAGNOSTIC GENETIC EVALUATION

History

Physical Examination

Laboratory Studies

Imaging Studies

DIAGNOSIS

Informational Resources

TREATMENT

GENETIC COUNSELING

Collaborative Approach

Follow-Up

SPECIFIC DISORDERS

Central Nervous System

Craniofacial

Pulmonary

Congenital Heart Disease

Gastrointestinal Tract

Ventral Wall Defects

Genitourinary/Renal

DEATH OF AN INFANT OR FETUS WITH ANOMALIES

DNA Banking

Fibroblast Culture

Autopsy

Imaging

GENETICS CONSULTATION

14. Anesthesiology

14.1: Anesthesia for Neonatal Surgical Emergencies

GENERAL PREOPERATIVE EVALUATION

Prenatal History

Physical Examination

EVALUATION OF ONGOING TREATMENT

Intake and Output of Fluids

EVALUATION OF MONITORING AND INTRAVENOUS ACCESS

Mandatory Monitors

CARDIOVASCULAR SYSTEM

Changing Cardiovascular Physiology

NEONATAL AUTONOMIC NERVOUS SYSTEM

Sympathetic System

Parasympathetic System

Neonatal Somatosensory System

RESPIRATORY SYSTEM

Physiology

Respiratory Failure

RENAL SYSTEM

Sodium Regulation

Glomerular Filtration Rate

HEMATOLOGIC SYSTEM

Hematologic Considerations

THERMOREGULATION

Causes of Hypothermia

Prevention of Hypothermia

NEED FOR ANESTHESIA

Effects of Anesthetic Agents

Anesthesia and Ablation of Stress Response

ANESTHETIC MANAGEMENT OF SPECIFIC NEONATAL CONDITIONS

Congenital Diaphragmatic Hernia

Esophageal Malformations

Omphalocele and Gastroschisis

Intestinal Obstruction

Necrotizing Enterocolitis

Meningomyeloceles and Meningoceles

Neonatal Tumors

CONCLUSION

ACKNOWLEDGMENT

14.2: Pain Assessment and Management

FETAL AND NEONATAL PHYSIOLOGIC RESPONSES TO PAIN

Neurodevelopmental Outcomes

PRINCIPLES OF PREVENTION AND MANAGEMENT OF NEONATAL PAIN AND STRESS

Principles of Pain Management

EVALUATING NEONATAL PAIN AND STRESS

Recommended Assessment Tools

MANAGEMENT: PAIN PREVENTION AND TREATMENT

Nonpharmacologic Approaches

Considerations for Pharmacologic Approaches

Pharmacologic Treatment of Procedure-Related Pain

Postoperative Analgesia

Reversal Agents

15. Health Maintenance and Discharge Planning

ROUTINE NEWBORN SCREENING

Newborn State Screen

Hearing Screening

IMMUNIZATIONS

Hepatitis B Vaccine

Two-Month Immunizations

Respiratory Syncytial Virus

INPATIENT AND OUTPATIENT SCREENING

Neurology

Ophthalmology

Early Intervention Program

Infant Follow-Up Program

DISCHARGE TEACHING

Well-Baby Care

Nutrition

VISITING NURSE

Communication

HOME SAFETY

CAR TRAVEL SAFETY

SPECIFIC MEDICAL DEVICES

Gastrostomy Tubes

Jejunostomy Tubes

Ostomies

Central Venous Lines

Tracheostomy

Index

 

An aparitie	noi 2024
Autor	Anne R. Hansen MD, MPH, Mark Puder MD, PhD
Dimensiuni	127 x 203 x 26 mm
Editura	LWW
Format	Paperback
ISBN	9781975222451
Limba	Engleza
Nr pag	704
Versiune digitala	DA