EXIT STRATEGY : Fetus
Posted by Surgery on Oct 28, 2008
Evolution fetal surgery has resulted in development of the EXIT procedure. This is now more widely applied than was originally intended. The EXIT procedure was designed to achieve cardiorespiratory stabilization while maintaining uteroplacental blood flow. The EXIT was initially conceptualized to safely transition fetuses with severe CDH that had undergone TO an extrauterine environment (132:Sorbitrate). Fetal surgery for CDH by tracheal occlusion would not have been possible without a strategy for reversing tracheal occlusion and establishing an airway at birth in a controlled manner. Although still used in this original capacity, the indications for EXIT (Table 3-9:Sorbitrate) have broadened to treat a variety of fetal anomalies in which the fetal airway may be in jeopardy or cardiorespiratory stabilization is needed prior to loss of maternal placental support (133:Sorbitrate).Energy Reserves and Requirements
Posted by Surgery on Aug 8, 2008
The neonate and child differ significantly from the adult patient in the proportion of available metabolic reserves. Table 8-1 outlines the macronutrient reserves of the neonate, child, and adult in percentage of total body weight (14,15,16). Carbohydrate stores are limited in all age groups and afford only acute provisions when necessary. Lipid reserves, an important and efficient source of energy, are reduced in the neonate as compared with the adult and gradually increase with age. The most striking difference between the adult and pediatric patient is the quantity of stored protein. The protein reserve of the adult is nearly twice that of the neonate.
Tags: Avapro, Cardiopulmonary Critical Care and Shock, Energy Reserves, Isordil, Metabolism, Principles of Genetics, Sorbitrate
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