Special considerations in the premature and ex-premature infant
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文摘
Ex-premature infants and children are a heterogenous population, ranging from healthy children born at 36 weeks' gestation to formerly extremely premature children with significant medical issues that affect anaesthetic care. Preterm birth is associated with perinatal mortality, neurological disability (including cerebral palsy), severe morbidity in the first weeks of life, prolonged hospital stay after birth, readmission to hospital in the first year of life and increased risk of chronic lung disease.Around 3% of newborns have a major congenital physical anomaly with 60% of congenital anomalies affecting the brain or heart and around 1% having multiple anomalies. Individual congenital conditions requiring surgical intervention in the neonatal period are rare. Gastroschisis is one of the most common abnormalities and has an incidence of around 1 in 2500 live births. Outside of the neonatal period, the most common surgical procedures performed in ex-premature infants are inguinal hernia repair and ophthalmologic procedures for underlying retinopathy of prematurity. After even minor surgical procedures, ex-premature infants are at higher risk for postoperative complications than infants born at term.
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