By V. Carpino, F. Borrometi, A. Natale, V. Peluso (auth.), I. Salvo MD, D. Vidyasagar MD (eds.)
The anesthesia and extensive care in babies and kids have assumed positions of basic significance in modern drugs. In those soft sectors of drugs, scientific examine actions needs to be consistently supported through interdisciplinary collaborations. Neonatal and pediatric extensive care calls for that every one concerned physicians, together with the physician and anesthesiologist, be keen to interact as a staff. besides the fact that, coordination of many of the pathophysiological and medical features of neonatal and pediatric serious drugs is extremely advanced. a whole and present assessment of the anaethesia and in depth care of babies and kids needs to comprise discussions of morbidity premiums, which will advisor the clincians in deciding upon the diagnostic technique, in addition to of monotoring concepts applicable to aid the healing selection. fresh development in extensive care drugs for babies and youngsters has been significant.
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Conservation of heat and humidity are of paramount importance. By reducing water and heat loss from the patient, the system should protect the airway mucosa and reduce the risk of pulmonary complications after prolonged surgery. In addition, dead space and resistance to breathing should be minimized. In children, the monitoring of airway pressure is very important. If anaesthesia is administered, concentration of inspired gases is strongly recommended. In centres where flammable agents are still in use, non-conductivity is essential.
Complex feedback control mechanisms exist to ensure homeostasis and involve the kidTable 2. 3 26 Total cations 151 Anions • Chloride • Bicarbonate • Phosphate • Sulfate • Organic acids • Protein 104 25 2 1 6 13 114 29 ±2 ±8 95 20 Total anions 151 Electrolytes 55 Choice of perioperative fluids and transfusion 41 neys, lungs, circulatory, and endocrine systems and the CNS. The maintenance of extracellular volume is centered around the control of the balance of sodium (renin-angiotensin-aldosterone system), while the most important determinant of the osmolarity of the body fluids is the excretion or retention of water by the kidneys, thirst mechanisms, and the intake of water (qntidiuretic hormone).
This author emphasizes the changes in the ratio ECF/ICF water from birth to the teenage years (Table 1). The preterm infant has a very high proportion of its total body weight as water, with two-thirds residing in the ECF. As the cells grow and multiply and organs develop, the intracellular proportion of the total body water increases with a corresponding reduction in the ECF. The normal electrolyte composition of body fluids is shown in Table 2. The total cations and anions within a particular fluid space must be equal [2J.