Infants can retain sodium but. Electrolytes requirements of the full term. Sodium 2 3 meqkgday, potassium 1 2 meqkgday, chloride 3 5. As. a rule of thumb, the daily fluid requirements can be approximated too prematures 1. Infants 1. 0kg 1. Special need of preterm babies fluid therapy are conservative. ECF tonicity. They are. High. intravenous therapy can lead to patent PDA, bronchopulmonary dysplasia. Impaired ability to. Estimations of daily fluid requirements should. Blood Volumes estimates of help during surgical blood loss are premature 8. The degree of dehydration can be measured by clinical parameters. Intravenous. is one of the major advances in neonatal surgery and will be required. Newborn infants. 1. This is increased during. Minimum daily requirement are 2 3. B. Variations in Individual Newborns. Types of Newborns Infantsa The full term, full size infant with a gestational age of 3. TAGA they received. The preterm infant with a gestational age below 3. Pre. TAGA c The small for gestational age infant SGA with a gestational age. A combination of b and c, i. The characteristic that most significantly affects the survival of. Between. 2. 7 and 2. It. is only after 3. Once there is adequate lung tissue, the critical factor that decides. Metabolic and Host Defenses. Handling of the breakdown products of hemoglobin is also a difficult. The ability of the immature liver to. Physiologic jaundice is, therefore, higher in the. Unfortunately, the immature. Other problems affecting the. Newborns have a poorly developed gluconeogenesis system. Immature infants can develop. The preterm and surgical neonate is more prone to. Symptoms are jitteriness and seizures with. Calcium maintenance is 5. Human beings. are homeothermic organisms because of thermoregulation. This. is maintained by a delicate balance between heat produced and heal. Heat production mechanisms are voluntary muscle activity increasing. Heat loss occurs from heat flow from center of the body to. There is an association between hypothermia. NICUs. The surgical neonate is prone to hypothermia. Infant produce heat by increasing metabolic activity and using brown. Below the 3. 5C the newborn experiences lassitude, depressed. Factors that precipitate. Practical considerations to maintain temperature. NICU procedures use radiant heater with skin. The newborns host defenses against infection. Total complement. C3,C4,C5 complex, factor B, and properdin. Ig. M, since it does not pass. Surgical Response of Newborns. The endocrine and metabolic response to surgical stress in newborns. NB is characterized by catabolic metabolism. An initial elevation in. Cortisol circadian. Cortisol is responsible for protein breakdown, release. Glucagon secretion is increased. Plasma insulin increase. During surgical stress NB release glucose, fatty. Early postoperative parenteral. Factors correlating with a prolonged catabolic response. They could be detrimental due to the NB limited reserves of nutrients. Anesthetics such as halothane and fentanyl can suppress. NB. II. NECK LESIONSA. Cervical Lymphadenopathy. An enlarged lymph node is the most common neck mass in children. Most. anterior to the sternocleidomastoid muscle. Infection is the usual. Acute. submandibular adenitis occur in early childhood 6 mo 3 yrs, is. URI, the child develops erythema, swelling and. Chronic adenitis. Other causes are 1 Mycobacterial adenitis. MAIS complex, swollen, non tender, nor inflamed, positive. Cat Scratch. caused by A. Fellis, transmitted by kittens, positive complement. Hodgkins disease mostly teenager and young adults, continuing. B. Congenital Torticollis. Congenital muscular torticollis is a disorder characterize by. SCM. and tilting of the head to the opposite side. This is the result of. SCM muscle. There is a relationship between birth. Congenital torticollis. Torticollis can develop at any age, although is more common during the. The SCM muscle can be a fibrous mass, or a. Management is conservative in most cases. The severity of restriction. Those. with failed medical therapy or the development of fascial. SCM muscle. C. Thyroglossal Duct Cysts. Thyroglossal duct cyst TDC is the most common congenital anterior. Symptoms appear at an average age of four with the sudden. Males are more commonly affected than females. TDC is. embryologic anomaly arising from epithelial remnant left after descent. The lining is. columnar or pseudostratified epithelium. TDC is associated to. A legally protective. Diagnosis is physical. Sonograms will show a cyst between 0. Once infected. excision is more difficult and recurrence will increase. Management is. Sistrunks operation Excision of cyst with resection of duct along. Extensive dissection can cause. The greatest opportunity for cure is surgery at initial non inflamed. Inadequate excision is a risk factor for further recurrence. D. Branchial Cleft Fistulas. Branchial cleft fistulas BCF originate from the 1st to 3rd branchial. Anomalies of the. They can be a cyst. Fistulas or sinus tract if they end. Management consists of excision since inefficient drainage may lead to. I have found that dissection along the tract up to the. This will prevent injury to nerves. Occasionally a second. BCF are uncommon, located at. They have a close association with the fascial nerve. BCF. very rare, run into the piriform sinus and may be a cause of acute. E. Cystic Hygroma. Cystic hygroma CH is an uncommon congenital lesion of the lymphatic. The etiology is intrauterine failure of lymphatics. Prenatal diagnosis can be done. Differential. includes teratomas, encephalocele, hemangiomas, etc. There is a strong. Turners syndrome 5. Noonans syndrome and chromosomic anomalies 1. Spontaneous. is less likely but can explain webbed neck of Turner and Noonans. Prenatal dx should be followed by cytogenetic analysis chorionic. CH. to determine fetal karyotype and provide counseling of pregnancy. Late. diagnosis 3. The airway should be. Intracystic injection of OK4. Streptococcus pyogenes caused cystic hygromas. III. OBSTRUCTIVE PROBLEMSLOGICAL APPROACH TO NEONATAL INTESTINAL. OBSTRUCTIONBy Jordan J. Child S Play Video Manual Handling Training© 2017