By John M. Hutson, Michael O’Brien, Spencer W. Beasley, Sebastian King
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Extra resources for Jones’ Clinical Paediatric Surgery
Mechanical ventilators have been designed specifically for neonatal use. IPPV is often combined with positive end-expiratory pressure (PEEP). PEEP is used for the same reasons as CPAP, that is as a means of improving oxygenation. The hazards of IPPV are greater than those of CPAP and relate directly to the pressure applied. Barotrauma to immature lungs may result in a chronic lung disease in neonates known as bronchopulmonary dysplasia. Intermittent mandatory ventilation is a technique of mechanical ventilation in which a predetermined minute volume is guaranteed, even when the patient breathes independently from the ventilator.
Hirschsprung-associated enterocolitis, either before or after the operation, may be life-threatening, with the outpouring of fluid stools causing rapid, severe e lectrolyte problems along with sepsis. Bowel dysfunction, with diarrhoea and soiling, may be a long-term problem. Meconium Ileus Cystic fibrosis causes a change in the physical properties of the meconium that fills the fetal gut. The meconium becomes excessively sticky and tenacious, leading to a Treatment is based on the assumption that the neonate has cystic fibrosis.
Often there is a history of maternal polyhydramnios. Diagnosis before feeding A firm 10-French catheter should be introduced via the mouth and passed gently down the oesophagus; if it becomes arrested at 9–11 cm from the lips, the diagnosis of oesophageal atresia has been established. A small catheter may curl up in the upper oesophagus and give a false impression of oesophageal continuity, hence the 10-French catheter [Fig. 2]. Ideally, oesophageal atresia should be diagnosed before the neonate is fed, because feeding may cause an acute episode of spluttering, coughing and cyanosis, with aspiration of milk into the lungs.
Jones’ Clinical Paediatric Surgery by John M. Hutson, Michael O’Brien, Spencer W. Beasley, Sebastian King