Abstract
The perioperative care of neonates and infants presents problems that differ greatly from those seen in older children and adults and has resulted, during the last few decades, in dramatically decreased morbidity and mortality rates in neonates and infants affected by congenital gastrointestinal malformations. Surgery-associated mortality in the neonate has declined from greater than 50% to less than 10%. Refined respiratory care, antibiotics and improved nutrition with a greater knowledge of the needs of the surgical patient have together improved the survival chances for surgical neonates and infants. This article reviews some important aspects of the perioperative care of the neonate and infant. Keywords: neonates, nutrition, postoperative care, surgery
Highlights
Advances in the perioperative care have dramatically decreased the morbidity and mortality rate in paediatric patients and especially among neonates affected by congenital gastrointestinalmalformations [1]
Antibiotics and improved nutrition with a greater knowledge of the needs of the surgical patients have together ameliorated the chances for surgical neonates and infants [2]
The nutritional requirements of adolescents and adults do not differ very much, so this review article will discuss the important factors for neonates and infants only in the perioperative period
Summary
Advances in the perioperative care have dramatically decreased the morbidity and mortality rate in paediatric patients and especially among neonates affected by congenital gastrointestinalmalformations [1]. Neonates have a high metabolic requirement and a small, limited nutritional reserve, in the low birth weight (LBW) infant [3]. There are some indications that longterm use of soybean-based fat emulsion, which has no eicosapentaenoic (EFA), or docosahexaenoic (DHA) and high levels of linolenic acid, does not support the development of the neonatal brain. After that period of time, use of parenteral nutrition without any enteral feeding is often associated with liver dysfunction (choleastasis), in LBW infants. It is of the utmost importance to give a few ml of breast milk by the enteral route even if the bowel is not functioning. Home parenteral nutrition can be used in infants, but this will not be discussed here
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