Anaesthesia and Intensive Care Medicine最新文献

英文中文

Anaesthesia for endoscopic upper airway surgery 内镜下上呼吸道手术的麻醉

IF 0.3 Q4 ANESTHESIOLOGY

Anaesthesia and Intensive Care Medicine

Pub Date : 2025-12-01 DOI: 10.1016/j.mpaic.2025.10.015

Moon-Moon Majumdar, Sneh Shah, Rajinder Singh Chaggar, Patrick A Ward

Endoscopic upper airway surgery involves accessing the larynx, trachea and upper aerodigestive tract via rigid or flexible endoscopy. These procedures are often performed for diagnostic or therapeutic management of airway pathology, including benign and malignant lesions. Anaesthetic management presents distinct challenges due to the shared airway, the need for optimal surgical access and the elevated risk of complications such as airway obstruction, inadequate lung ventilation and airway fire. A thorough preoperative assessment is essential, including evaluation of pathology characteristics, airway patency and patient co-morbidities. Anaesthetic planning must involve multidisciplinary collaboration. Oxygenation strategies include closed systems (e.g. conventional ventilation via microlaryngeal and laser-resistant tracheal tubes) and open systems (e.g. jet ventilation, spontaneous or apnoeic oxygenation with high-flow nasal oxygen). Each has specific indications, limitations and safety considerations. Tracheal extubation may carry significant risk and should follow a structured, risk-based approach. This article provides an in-depth overview of anaesthetic considerations, techniques and safety strategies for endoscopic upper airway surgery, highlighting the importance of planning, teamwork and adaptability in managing complex airway scenarios.

内镜下上呼吸道手术包括通过刚性或柔性内窥镜进入喉部、气管和上呼吸道。这些程序通常用于气道病理的诊断或治疗管理，包括良性和恶性病变。由于共用气道，需要最佳的手术通道，以及气道阻塞、肺通气不足和气道着火等并发症的风险增加，麻醉管理面临着独特的挑战。全面的术前评估是必要的，包括病理特征、气道通畅和患者合并症的评估。麻醉计划必须涉及多学科合作。氧合策略包括封闭系统（如通过微喉和耐激光气管管进行常规通气）和开放系统（如喷射通气、高流量鼻氧自发或无呼吸氧合）。每一种都有特定的适应症、局限性和安全考虑。气管拔管可能有很大的风险，应该遵循一个结构化的、基于风险的方法。本文深入概述了内镜下上呼吸道手术的麻醉注意事项、技术和安全策略，强调了计划、团队合作和适应性在管理复杂气道场景中的重要性。

{"title":"Anaesthesia for endoscopic upper airway surgery","authors":"Moon-Moon Majumdar, Sneh Shah, Rajinder Singh Chaggar, Patrick A Ward","doi":"10.1016/j.mpaic.2025.10.015","DOIUrl":"10.1016/j.mpaic.2025.10.015","url":null,"abstract":"<div><div>Endoscopic upper airway surgery involves accessing the larynx, trachea and upper aerodigestive tract via rigid or flexible endoscopy. These procedures are often performed for diagnostic or therapeutic management of airway pathology, including benign and malignant lesions. Anaesthetic management presents distinct challenges due to the shared airway, the need for optimal surgical access and the elevated risk of complications such as airway obstruction, inadequate lung ventilation and airway fire. A thorough preoperative assessment is essential, including evaluation of pathology characteristics, airway patency and patient co-morbidities. Anaesthetic planning must involve multidisciplinary collaboration. Oxygenation strategies include closed systems (e.g. conventional ventilation via microlaryngeal and laser-resistant tracheal tubes) and open systems (e.g. jet ventilation, spontaneous or apnoeic oxygenation with high-flow nasal oxygen). Each has specific indications, limitations and safety considerations. Tracheal extubation may carry significant risk and should follow a structured, risk-based approach. This article provides an in-depth overview of anaesthetic considerations, techniques and safety strategies for endoscopic upper airway surgery, highlighting the importance of planning, teamwork and adaptability in managing complex airway scenarios.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"26 12","pages":"Pages 840-846"},"PeriodicalIF":0.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gas, tubes and flow 气体、管道和流动

IF 0.3 Q4 ANESTHESIOLOGY

Anaesthesia and Intensive Care Medicine

Pub Date : 2025-12-01 DOI: 10.1016/j.mpaic.2025.10.021

Séamus Flynn, Craig Lyons

The flow of liquids and gases is relevant to many areas of practice in anaesthesia and critical care medicine. This article describes the principles governing flow, including the differences between laminar and turbulent flow and the factors that influence flow patterns. The Bernoulli principle and the Venturi effect are explained with clinical examples. Additional focus is afforded to high-flow nasal oxygen and jet ventilation therapies.

液体和气体的流动与麻醉和重症监护医学的许多实践领域有关。本文描述了控制流动的原理，包括层流和湍流之间的差异以及影响流动模式的因素。用临床实例说明了伯努利原理和文丘里效应。额外的重点是给予高流量鼻氧和喷气通气疗法。

引用次数: 0

Neonatal pharmacology 新生儿药理学

IF 0.3 Q4 ANESTHESIOLOGY

Anaesthesia and Intensive Care Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.mpaic.2025.10.002

Peter B Brooks, Ilya Kantsedikas

Neonates possess unique pharmacokinetic and pharmacodynamic characteristics attributable to the developmental immaturity of their organ systems, enzymatic pathways and overall body composition. These attributes underscore the necessity for specialised expertise to ensure safe and effective drug administration in neonatal anaesthesia. Throughout the first year of postnatal development, rapid growth leads to substantial alterations in drug metabolism and pharmacological response. The variability observed in drug disposition and efficacy among neonates is primarily due to immature enzymatic function, progressive anatomical and physiological changes and pharmacogenomic factors. Post-menstrual age is a reasonable indicator for assessing the maturation of clearance pathways. Dosing strategies in neonatal anaesthesia must account for the distinctive physiological features of newborns, encompassing pharmacokinetics, pharmacodynamics, susceptibility to adverse effects, and diverse disease states. Although current monitoring techniques, except for neuromuscular assessments, remain limited, advances in evaluating anaesthetic depth, sedation and pain management are anticipated to further improve safety and efficacy within this vulnerable population.

新生儿具有独特的药代动力学和药效学特征，归因于其器官系统发育不成熟，酶途径和整体身体组成。这些特点强调了在新生儿麻醉中需要专门知识以确保安全有效的给药。在出生后发育的第一年，快速生长导致药物代谢和药理反应的实质性改变。在新生儿中观察到的药物配置和疗效的差异主要是由于酶功能不成熟、解剖和生理变化的进展以及药物基因组学因素。经后年龄是评估清除途径成熟程度的合理指标。新生儿麻醉的剂量策略必须考虑到新生儿的独特生理特征，包括药代动力学、药效学、对不良反应的易感性和不同的疾病状态。尽管目前的监测技术（除了神经肌肉评估）仍然有限，但在评估麻醉深度、镇静和疼痛管理方面的进展有望进一步提高这一弱势群体的安全性和有效性。

{"title":"Neonatal pharmacology","authors":"Peter B Brooks, Ilya Kantsedikas","doi":"10.1016/j.mpaic.2025.10.002","DOIUrl":"10.1016/j.mpaic.2025.10.002","url":null,"abstract":"<div><div>Neonates possess unique pharmacokinetic and pharmacodynamic characteristics attributable to the developmental immaturity of their organ systems, enzymatic pathways and overall body composition. These attributes underscore the necessity for specialised expertise to ensure safe and effective drug administration in neonatal anaesthesia. Throughout the first year of postnatal development, rapid growth leads to substantial alterations in drug metabolism and pharmacological response. The variability observed in drug disposition and efficacy among neonates is primarily due to immature enzymatic function, progressive anatomical and physiological changes and pharmacogenomic factors. Post-menstrual age is a reasonable indicator for assessing the maturation of clearance pathways. Dosing strategies in neonatal anaesthesia must account for the distinctive physiological features of newborns, encompassing pharmacokinetics, pharmacodynamics, susceptibility to adverse effects, and diverse disease states. Although current monitoring techniques, except for neuromuscular assessments, remain limited, advances in evaluating anaesthetic depth, sedation and pain management are anticipated to further improve safety and efficacy within this vulnerable population.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"26 11","pages":"Pages 730-738"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Local anaesthetic drugs 局部麻醉药物

IF 0.3 Q4 ANESTHESIOLOGY

Anaesthesia and Intensive Care Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.mpaic.2025.10.009

Sarah L Perrin, Catherine Bernard, Sheila Black

Local anaesthetics (LA) are weak bases consisting of a lipophilic aromatic ring linked to a hydrophilic tertiary amine by either an ester or amide bond. It is this chemical link that enables classification of the LA. They exist in solution as an equilibrium of ionized and unionized forms. The unionized form is free to diffuse across the axonal membrane, but it is the ionized form which then binds and blocks the intracellular portion of the voltage-gated sodium channel, preventing sodium influx and nerve transmission. Neuronal activity and nerve fibre diameter determine neuronal sensitivity; whereas pKa, lipid solubility, protein binding and inherent vasomotor activity affect the pharmacological properties of the LA. LAs can be administered by a variety of methods depending on clinical requirement including topical, local infiltration, intravenous and neuraxial and peripheral nerve blockade. While generally safe, the toxic effects of LAs can have wide-ranging effects including methaemoglobinaemia and systemic toxicity. The effects of ion trapping, stereoisomers, and additives have significant clinical consequences and require special consideration.

局部麻醉剂（LA）是一种弱碱，由亲脂性芳香环通过酯或酰胺键与亲水性叔胺相连。正是这种化学联系使LA得以分类。它们以离子化和非离子化的平衡形式存在于溶液中。未结合的形式可以自由地在轴突膜上扩散，但它是电离的形式，然后结合并阻断电压门控钠通道的细胞内部分，阻止钠流入和神经传递。神经元活动和神经纤维直径决定神经元敏感性；而pKa、脂溶性、蛋白结合和固有的血管舒缩活性影响LA的药理学性质。根据临床需要，LAs可以通过多种方法给予，包括局部、局部浸润、静脉、轴突和周围神经阻断。虽然总体上是安全的，但LAs的毒性作用可能具有广泛的影响，包括甲基血红蛋白血症和全身毒性。离子捕获、立体异构体和添加剂的影响具有重要的临床后果，需要特别考虑。

引用次数: 0

The treatment of hypertensive disorders in pregnancy 妊娠期高血压疾病的治疗

IF 0.3 Q4 ANESTHESIOLOGY

Anaesthesia and Intensive Care Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.mpaic.2025.10.010

Elizabeth Routledge, Sarah Marsden

Hypertensive disorders are among the most common complications of pregnancy, affecting 8–10% of all pregnancies. They include gestational hypertension, pre-eclampsia and eclampsia, as well as pregnant patients with pre-existing chronic hypertension. Over the last 70 years, there has been marked decline in maternal mortality associated with hypertension.

The development of pre-eclampsia and eclampsia is mediated by the placenta, and results in a widespread inflammatory response with consequent endothelial dysfunction and thus both multisystem maternal organ dysfunction and uteroplacental failure. The identification of patients at risk and the early diagnosis and therefore treatment of patients who develop pre-eclampsia can be life-saving to both mother and fetus.

A patient with a hypertensive disorder of pregnancy presents specific considerations for the obstetric anaesthetist around timing and mechanism of delivery, including the implications for delivery of both regional and general anaesthesia. The most unwell patients may need to be managed in a critical care environment. These considerations all require a strong multidisciplinary approach involving anaesthetics, critical care, obstetrics, and paediatrics.

高血压疾病是妊娠最常见的并发症之一，影响所有妊娠的8-10%。它们包括妊娠期高血压、先兆子痫和子痫，以及已有慢性高血压的孕妇。在过去70年中，与高血压相关的孕产妇死亡率显著下降。先兆子痫和子痫的发展是由胎盘介导的，并导致广泛的炎症反应，随之而来的内皮功能障碍，从而导致母体多系统器官功能障碍和子宫胎盘功能衰竭。识别有风险的患者，早期诊断并对先兆子痫患者进行治疗，对母亲和胎儿都可以挽救生命。妊娠期高血压疾病患者向产科麻醉师提出了关于分娩时机和机制的具体考虑，包括对局部麻醉和全身麻醉的影响。最不舒服的病人可能需要在重症监护环境中进行管理。这些考虑都需要强有力的多学科方法，包括麻醉、重症监护、产科和儿科。

{"title":"The treatment of hypertensive disorders in pregnancy","authors":"Elizabeth Routledge, Sarah Marsden","doi":"10.1016/j.mpaic.2025.10.010","DOIUrl":"10.1016/j.mpaic.2025.10.010","url":null,"abstract":"<div><div>Hypertensive disorders are among the most common complications of pregnancy, affecting 8–10% of all pregnancies. They include gestational hypertension, pre-eclampsia and eclampsia, as well as pregnant patients with pre-existing chronic hypertension. Over the last 70 years, there has been marked decline in maternal mortality associated with hypertension.</div><div>The development of pre-eclampsia and eclampsia is mediated by the placenta, and results in a widespread inflammatory response with consequent endothelial dysfunction and thus both multisystem maternal organ dysfunction and uteroplacental failure. The identification of patients at risk and the early diagnosis and therefore treatment of patients who develop pre-eclampsia can be life-saving to both mother and fetus.</div><div>A patient with a hypertensive disorder of pregnancy presents specific considerations for the obstetric anaesthetist around timing and mechanism of delivery, including the implications for delivery of both regional and general anaesthesia. The most unwell patients may need to be managed in a critical care environment. These considerations all require a strong multidisciplinary approach involving anaesthetics, critical care, obstetrics, and paediatrics.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"26 11","pages":"Pages 785-791"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The transition to life outside the womb: a review of neonatal physiology 向子宫外生活的过渡：新生儿生理学综述

IF 0.3 Q4 ANESTHESIOLOGY

Anaesthesia and Intensive Care Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.mpaic.2025.10.001

Babette Clinck, Carrick Allison, Francesca Patino

The transition from intrauterine to extrauterine life represents a complex physiological process, requiring rapid, coordinated adaptation across all major organ systems in a specific, sequential and interdependent fashion. This transition begins with abrupt and dramatic changes in organ function, followed by a more gradual phase of maturation. The success of this process depends on both structural maturity and precise timing.

This article offers a clear and concise overview of the key physiological adaptations required for extrauterine life, outlining the major changes in each organ system and highlighting their intricate interplay. Additionally, it touches on the challenges of preterm birth, where the critical developmental preparations of the third trimester of gestation are disrupted, leaving preterm infants particularly vulnerable during the immediate postnatal period.

从宫内生命到宫外生命的过渡是一个复杂的生理过程，需要所有主要器官系统以特定的、顺序的和相互依赖的方式快速、协调地适应。这种转变始于器官功能的突然和剧烈变化，随后是一个更渐进的成熟阶段。这一过程的成功取决于结构的成熟度和精确的时机。这篇文章提供了一个清晰而简洁的概述体外生命所需的关键生理适应，概述了每个器官系统的主要变化，并强调了它们之间复杂的相互作用。此外，它还涉及到早产的挑战，其中妊娠晚期的关键发育准备工作受到破坏，使早产儿在产后特别容易受到伤害。

引用次数: 0

Special considerations in the premature and ex-premature infant 早产儿和前早产儿的特殊注意事项

IF 0.3 Q4 ANESTHESIOLOGY

Anaesthesia and Intensive Care Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.mpaic.2025.10.004

Natasha Mackinnon, Vimmi Oshan

Premature and ex-premature infants represent a particularly high-risk group in anaesthetic practice due to ongoing physiological immaturity, limited physiological reserve and a heightened susceptibility to perioperative complications. While advances in neonatal care have significantly improved survival rates among extremely preterm neonates, this has resulted in an increasing number of vulnerable infants requiring anaesthesia for surgical and diagnostic procedures during early infancy. These patients exhibit altered pharmacokinetics, pharmacodynamics and immature organ systems that necessitate a highly individualized approach to perioperative management.

Postmenstrual age (PMA) remains a key determinant of anaesthetic risk, particularly in relation to apnoea of prematurity and the potential neurodevelopmental effects of anaesthetic exposure. Common surgical indications in this population, such as necrotizing enterocolitis, patent ductus arteriosus and retinopathy of prematurity, present unique anaesthetic challenges requiring specialized strategies.

This review provides a comprehensive, system-based and perioperative phase-oriented guide to anaesthesia in the premature and ex-premature infant. It emphasizes the importance of preoperative optimization, intraoperative vigilance and meticulous postoperative monitoring within specialist centres. Multidisciplinary collaboration is essential to reduce perioperative morbidity and optimize outcomes in this vulnerable cohort.

早产儿和前早产儿由于持续的生理不成熟、有限的生理储备和对围手术期并发症的高度易感性，在麻醉实践中是一个特别高风险的群体。虽然新生儿护理的进步大大提高了极早产儿的存活率，但这也导致越来越多的脆弱婴儿在婴儿期早期需要麻醉进行手术和诊断程序。这些患者表现出药代动力学、药效学改变和器官系统不成熟，需要高度个性化的围手术期管理方法。经后年龄（PMA）仍然是麻醉风险的关键决定因素，特别是与早产儿呼吸暂停和麻醉暴露的潜在神经发育影响有关。在这一人群中常见的手术指征，如坏死性小肠结肠炎、动脉导管未闭和早产儿视网膜病变，呈现出独特的麻醉挑战，需要专门的策略。这篇综述为早产儿和前早产儿的麻醉提供了一个全面的、系统的和围手术期导向的指导。它强调术前优化，术中警惕和细致的术后监测在专科中心的重要性。多学科合作对于减少围手术期发病率和优化这一弱势群体的预后至关重要。

{"title":"Special considerations in the premature and ex-premature infant","authors":"Natasha Mackinnon, Vimmi Oshan","doi":"10.1016/j.mpaic.2025.10.004","DOIUrl":"10.1016/j.mpaic.2025.10.004","url":null,"abstract":"<div><div>Premature and ex-premature infants represent a particularly high-risk group in anaesthetic practice due to ongoing physiological immaturity, limited physiological reserve and a heightened susceptibility to perioperative complications. While advances in neonatal care have significantly improved survival rates among extremely preterm neonates, this has resulted in an increasing number of vulnerable infants requiring anaesthesia for surgical and diagnostic procedures during early infancy. These patients exhibit altered pharmacokinetics, pharmacodynamics and immature organ systems that necessitate a highly individualized approach to perioperative management.</div><div>Postmenstrual age (PMA) remains a key determinant of anaesthetic risk, particularly in relation to apnoea of prematurity and the potential neurodevelopmental effects of anaesthetic exposure. Common surgical indications in this population, such as necrotizing enterocolitis, patent ductus arteriosus and retinopathy of prematurity, present unique anaesthetic challenges requiring specialized strategies.</div><div>This review provides a comprehensive, system-based and perioperative phase-oriented guide to anaesthesia in the premature and ex-premature infant. It emphasizes the importance of preoperative optimization, intraoperative vigilance and meticulous postoperative monitoring within specialist centres. Multidisciplinary collaboration is essential to reduce perioperative morbidity and optimize outcomes in this vulnerable cohort.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"26 11","pages":"Pages 745-752"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Resuscitation of the newborn 新生儿复苏

IF 0.3 Q4 ANESTHESIOLOGY

Anaesthesia and Intensive Care Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.mpaic.2025.10.006

Ruth Vaughan, Sarah Greenaway, Geraint Lee

Neonatal resuscitation can feel daunting to the anaesthetist as it differs to all other forms of resuscitation due to the physiological changes which occur at birth. Although not routine, anaesthetic input may be required in those cases requiring resuscitation, and here we aim to familiarize anaesthetists with the principles and guidance for neonatal resuscitation in the UK.

新生儿复苏可能会让麻醉师感到畏惧，因为它不同于所有其他形式的复苏，这是由于出生时发生的生理变化。虽然不是常规的，但在那些需要复苏的病例中可能需要麻醉，在这里，我们的目标是让麻醉师熟悉英国新生儿复苏的原则和指导。

引用次数: 0

Acute pain management in the neonate 新生儿急性疼痛的处理

IF 0.3 Q4 ANESTHESIOLOGY

Anaesthesia and Intensive Care Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.mpaic.2025.10.005

Bryan Atandi, James Masters, Philip Arnold

Neonates may require painful procedures whilst in hospital. Anaesthetists may be called upon to help manage neonates in pain. Developmental differences in anatomy and physiology cause challenges when considering appropriate analgesic strategies. A multimodal approach, with careful modification of established analgesic practices, is required to both minimize the negative sequelae of pain and limit adverse effects. Those tasked with the care of neonates should be familiar with the different analgesic options at their disposal, utilizing a combination of non-pharmacologic, pharmacologic and interventional strategies in order to improve patient care.

新生儿在住院期间可能需要进行痛苦的手术。麻醉师可能被要求帮助处理新生儿的疼痛。在考虑适当的镇痛策略时，解剖学和生理学的发育差异造成了挑战。需要一种多模式的方法，仔细修改已建立的镇痛方法，以尽量减少疼痛的负面后遗症和限制不良反应。那些负责照顾新生儿的人应该熟悉不同的镇痛选择，利用非药物、药物和介入性策略的组合，以改善病人的护理。

引用次数: 0

Medical illnesses in neonates: implications for anaesthesia 新生儿医学疾病：麻醉的意义

IF 0.3 Q4 ANESTHESIOLOGY

Anaesthesia and Intensive Care Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.mpaic.2025.10.007

Jacinth Tan, Katie Misselbrook

Neonates present a specific set of challenges to the anaesthetist due to neonatal anatomy and physiology that is very different from that in children and adults. These challenges increase when the neonate is premature, but also if they have associated co-morbidities. There are certain medical conditions that exclusively affect neonates, or that affects neonates more commonly and significantly. When they present for anaesthesia and surgery, it is essential that the anaesthetist understands the implications of these co-morbid problems. A multidisciplinary approach involving neonatologists and other sub-specialists should be sought to ensure safe perioperative management of the ongoing medical issue. This article aims to address some common medical diagnoses and considerations for safe anaesthesia in these babies.

由于新生儿的解剖和生理与儿童和成人非常不同，新生儿对麻醉师提出了一套特殊的挑战。当新生儿早产时，这些挑战会增加，但如果他们有相关的合并症也会增加。有某些医疗条件只影响新生儿，或者更普遍和显著地影响新生儿。当他们进行麻醉和手术时，麻醉师了解这些共病问题的含义是至关重要的。应寻求涉及新生儿学家和其他专科医生的多学科方法，以确保对正在进行的医疗问题的围手术期安全管理。这篇文章的目的是解决一些常见的医学诊断和安全麻醉这些婴儿的注意事项。

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Anaesthesia and Intensive Care Medicine

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀