Four monitors are used for virtually every pediatric anesthesia case: pulse oximetry, capnography, electrocardiogram (ECG), and blood pressure measurement. These monitors are components of the Basic Monitoring Standards of the American Society of Anesthesiologists. Temperature monitoring is also performed except…
A variety of intravenous fluid and blood products are administered to children in the perioperative period. Indications include preoperative deficit replacement, ongoing maintenance requirements, fluid loss replacement, and treatment of anemia and hypovolemia. This chapter describes the use of these…
The “10 P” Checklist Cognitive aids, in the form of checklists, are techniques that ensure completeness with multistep processes and aid attention to detail. We devised the 10 P checklist to help anesthesia providers prepare for cases ( Table 13.1…
With the advent of antenatal steroids, surfactant therapy, and the overall improvement in care of extremely premature infants, mortality from medical problems of prematurity has decreased. However, as survival rates of premature infants increase, the incidence of chronic medical conditions…
In the last several decades, the incidence of prematurity in the United States has risen to 11.5%. Maternal risk factors for prematurity include absence of prenatal care, low socioeconomic status, tobacco abuse, poor nutrition and genitourinary tract infections, to name…
Diabetes Mellitus The endocrine condition most frequently encountered in the perioperative period in children is diabetes mellitus. Diabetes mellitus is the result of an absolute or functional deficiency of insulin production by the pancreas. In type 1 diabetes, this deficiency…
Trisomy 21 (Down Syndrome) With an incidence of approximately1 in 700 live births , trisomy 21 is the most common chromosomal abnormality and the most common cause of intellectual disability associated with genetic disease. These children are characterized by their…
Common Oncologic Disorders Leukemia The leukemias, which result from malignant transformation of early hematopoietic stem cells, are some of the most common malignancies of childhood ( Table 8.1 ). Acute lymphoblastic leukemia (ALL) accounts for 75% of all childhood acute…
Inherited Coagulation Disorders Hemophilia The hemophilias are a group of X-linked recessive bleeding disorders characterized by insufficient production of coagulation factor VIII (hemophilia A) or factor IX (hemophilia B). Formation of the platelet plug (primary hemostasis) is normal; however, stabilization…
Gastroesophageal Reflux Gastroesophageal reflux (GER) is a term used to describe a leaky lower esophageal sphincter that causes a child to regurgitate recently ingested meals. It is common in the first year of life, especially in children born premature, and…