Newborn Emergencies

  • Robert S. Holzman
  • Thomas J. Mancuso
  • Navil F. Sethna
  • James A. DiNardo


A 14-h-old male, 2,400 g, born at 37 weeks gestational age, is scheduled emergently for repair of esophageal atresia with tracheoesophageal fistula. The newborn choked and gagged on the first glucose water feed. A contrast study confirmed the diagnosis. Vital signs are BP = 88/52 mmHg, RR = 44/min, P = 158 bpm, T = 37.2°C. His hemoglobin is 13.0 g/dL. An NG tube is in place. The infant is receiving nasal cannula oxygen at 300 mL/min.


Cystic Fibrosis Positive Pressure Ventilation Esophageal Atresia Congenital Diaphragmatic Hernia Pyloric Stenosis 
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  1. 1.
    Seefelder C (2008) Abdominal tumors. In: Holzman RS, Mancuso TJ, Polaner DM (eds) Practical aspects of pediatric anesthesia. Wolters Kluwer Lippincott Williams and Wilkins, Philadelphia, pp 437–440Google Scholar
  2. 2.
    Kluth D, Steding G, Seidl W (1987) The embryology of foregut malformations. J Pediatr Surg 22:389–393PubMedCrossRefGoogle Scholar
  3. 3.
    Kang BKB (2008) The foregut and chest. In: Holzman RS, Mancuso TJ, Polaner DM (eds) Practical aspects of pediatric anesthesia. Wolters Kluwer Lippincott Williams and Wilkins, Philadelphia, pp 391–392Google Scholar
  4. 4.
    Karl HW (1985) Control of life-threatening air leak after gastrostomy in an infant with respiratory distress syndrome and tracheoesophageal fistula. Anesthesiology 62:670–672PubMedCrossRefGoogle Scholar
  5. 5.
    Koka B, Chacko SK (2006) Airway management of a newborn with trascheoesophageal fistula. In: Murphy M, Hung O (eds) Airway management and monitoring manual. McGraw-Hill, New YorkGoogle Scholar
  6. 6.
    Filston HC, Chitwood WR Jr, Schkolne B, Blackmon LR (1982) The Fogarty balloon catheter as an aid to management of the infant with esophageal atresia and tracheoesophageal fistula complicated by severe RDS or pneumonia. J Pediatr Surg 17:149–151PubMedCrossRefGoogle Scholar
  7. 7.
    Andropoulos DB, Rowe RW, Betts JM (1998) Anaesthetic and surgical airway management during tracheo-oesophageal fistula repair. Paediatr Anaesth 8:313–319PubMedCrossRefGoogle Scholar
  8. 8.
    Murrell D, Gibson PR, Cohen RC (1993) Continuous epidural analgesia in newborn infants undergoing major surgery. J Pediatr Surg 28:548–552; discussion 52–3Google Scholar
  9. 9.
    Valairucha S, Seefelder C, Houck CS (2002) Thoracic epidural catheters placed by the caudal route in infants: the importance of radiographic confirmation. Paediatr Anaesth 12:424–428PubMedCrossRefGoogle Scholar
  10. 10.
    Tyler DC (1989) Respiratory effects of pain in a child after thoracotomy. Anesthesiology 70:873–874PubMedCrossRefGoogle Scholar
  11. 11.
    Karamanoukian HL, Glick PL, Wilcox DT et al (1995) Pathophysiology of congenital diaphragmatic hernia. XI: Anatomic and biochemical characterization of the heart in the fetal lamb CDH model. J Pediatr Surg 30:925–928; discussion 9Google Scholar
  12. 12.
    Harrison MR, Keller RL, Hawgood SB et al (2003) A randomized trial of fetal endoscopic tracheal occlusion for severe fetal congenital diaphragmatic hernia. N Engl J Med 349:1916–1924PubMedCrossRefGoogle Scholar
  13. 13.
    Schwartz SM, Vermilion RP, Hirschl RB (1994) Evaluation of left ventricular mass in children with left-sided congenital diaphragmatic hernia. J Pediatr 125:447–451PubMedCrossRefGoogle Scholar
  14. 14.
    Reickert CA, Hirschl RB, Atkinson JB et al (1998) Congenital diaphragmatic hernia survival and use of extracorporeal life support at selected level III nurseries with multimodality support. Surgery 123:305–310PubMedCrossRefGoogle Scholar
  15. 15.
    Karamanoukian HL, Glick PL, Zayek M et al (1994) Inhaled nitric oxide in congenital hypoplasia of the lungs due to diaphragmatic hernia or oligohydramnios. Pediatrics 94:715–718PubMedGoogle Scholar
  16. 16.
    Holzman R (2008) The Body Cavity and Wall. In: Holzman RS, Mancuso TJ, Polaner DM (eds) Practical aspects of pediatrics of anesthesia. Wolters Kluwer Lippincoll Williamns and Wilkins, Philadelphia, pp 295–299Google Scholar
  17. 17.
    MacDonald NJ, Fitzpatrick GJ, Moore KP et al (1987) Anaesthesia for congenital hypertrophic pyloric stenosis. A review of 350 patients. Br J Anaesth 59:672–677PubMedCrossRefGoogle Scholar
  18. 18.
    Davis PJ, Galinkin J, McGowan FX et al (2001) A randomized multicenter study of remifentanil compared with halothane in neonates and infants undergoing pyloromyotomy. I. Emergence and recovery profiles. Anesth Analg 93:1380–1386, table of contentsGoogle Scholar
  19. 19.
    Cook-Sather SD, Tulloch HV, Liacouras CA, Schreiner MS (1997) Gastric fluid volume in infants for pyloromyotomy. Can J Anaesth 44:278–283PubMedCrossRefGoogle Scholar
  20. 20.
    Campbell BT, McLean K, Barnhart DC et al (2002) A comparison of laparoscopic and open pyloromyotomy at a teaching hospital. J Pediatr Surg 37:1068–1071; discussion -71Google Scholar
  21. 21.
    Cote CJ (1978) The anesthetic management of congenital lobar emphysema. Anesthesiology 49:296–298PubMedCrossRefGoogle Scholar
  22. 22.
    Goto H, Boozalis ST, Benson KT, Arakawa K (1987) High-frequency jet ventilation for resection of congenital lobar emphysema. Anesth Analg 66:684–686PubMedCrossRefGoogle Scholar
  23. 23.
    Raghavendran S, Diwan R, Shah T, Vas L (2001) Continuous caudal epidural analgesia for congenital lobar emphysema: a report of three cases. Anesth Analg 93:348–350; 3rd contents pageGoogle Scholar
  24. 24.
    Hartman GE, Boyajian MJ, Choi SS et al (2005) Surgical care of conditions presenting in the newborn. In: MacDonald MG, Mullet MD, Seshia MMK (eds) Avery’s neonatology, 6th edn. Lippincott Williams & Wilkins, Philadelphia, pp 1119–1120Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Robert S. Holzman
    • 1
  • Thomas J. Mancuso
    • 1
  • Navil F. Sethna
    • 1
  • James A. DiNardo
    • 1
  1. 1.Children’s Hospital BostonHarvard Medical SchoolBostonUSA

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