Anaes Vivas · Paediatric anaesthesia
Neonatal anaesthesia and the ex-preterm infant — viva
Structured oral examination station for neonatal-anaesthesia-prematurity.
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Target exams
ANZCAFRCAEDAICABAFCAI
Prompt
Growth chart and PMA calculator; apnoea monitor printout; hernia repair consent form.
PMA
Calculate the postmenstrual age and place it in the apnoea window: in nonanaemic infants free of recovery-room apnoea, Cote's combined analysis put the risk at no less than 5% (95% confidence) until 48 weeks postconceptual age at gestational age 35, and no less than 1% until 56 weeks at gestational age 32. Review bronchopulmonary dysplasia, apnoeas, anaemia, intercurrent respiratory infection and airway anomaly — the last two raise laryngospasm risk (upper respiratory infection OR 2.03, airway anomaly OR 3.35).[4][3]
References5ShowHide
- [1]Davidson AJ et al. Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial. Lancet, 2016.PMID 26507180
- [2]McCann ME et al. Neurodevelopmental outcome at 5 years of age after general anaesthesia or awake-regional anaesthesia in infancy (GAS): an international, multicentre, randomised, controlled equivalence trial. Lancet, 2019.PMID 30782342
- [3]Flick RP et al. Risk factors for laryngospasm in children during general anesthesia. Paediatric Anaesthesia, 2008.PMID 18315633
- [4]Coté CJ et al. Postoperative apnea in former preterm infants after inguinal herniorrhaphy. A combined analysis. Anesthesiology, 1995.PMID 7717551
- [5]Carlo WA et al. Target ranges of oxygen saturation in extremely preterm infants. N Engl J Med, 2010.PMID 20472937