Anesthesia & Clinical Research
Open Access

Anesthesia for the micropremie

4^th International Anesthesia and Pain Medicine Conference

December 13-14, 2018 Abu Dhabi, UAE

Hany Mohamed Elzahaby

Ain Shams University, Egypt

Scientific Tracks Abstracts: J Anesth Clin Res

Abstract :

The Micropremies are preterm neonates is borne before 30 gestational weeks and have extremely low birth weight infants (<1000 g). Morbidity and mortality in this population has decreased over the past decades and general anesthesia is increasingly needed for surgical and diagnostic procedures. Knowing their unique physiological features is necessary. Common complications of prematurity include: postoperative apnea, broncho-pulmonary dysplasia, patent ductus arteriosus (PDA), right to left shunt, intraventricular hemorrhage, long term cognitive impairment, retinopathy of prematurity, altered temperature regulation with impaired renal and metabolic functions. The debate continues upon who should provide the care and where to do these cases. Preoperative preparation focuses on optimization of cardiac and respiratory status and on treatment of anemia, electrolyte abnormalities, metabolic acidosis and coagulopathy. There are 2 common scenarios, the first is a relatively stable micropremie with a secured IV access coming for ligation of PDA where a high dose fentanyl and a relaxant will do the job. The second scenario is an unstable micropremie with difficult venous access, hypothermic, hemodynamically unstable with coagulopathy and thrombocytopenia coming for laparotomy for NEC. Management differs if they are on conventional ventilation or on HFOV. Permissive hypercarbia is common in NICU setting. The decision to conventionally or manually ventilate them is critial as they usually go hypocapnic and hypocalcemic that may be detrimental to their myocardium. Common problems are hypotension and hypovolenia, hypothetmia, hypocapnia and hypocalcemia.

Biography :

Hany Mohamed Elzahaby is the Professor and Head of Anesthesia, Intensive Care and Pain Management Department, Ain Shams University, Egypt. His Achievements include: Head of Pediatric Anesthesia Unit, Ain Shams University, 2010-2018, Specialist Registered in Anesthesia, United Kingdom 2007, Consultant Anesthetist, North West Armed Forces Hospital, Kingdom Of Saudi Arabia 1999-2007, Degree of Doctor in Anesthesia, Ain Shams University, 1994, Fellowship in Anesthesia, University of Iowa, United States of America 1992-1994, Master Degree in Anesthesia, Ain Shams University, 1989, Bachelor Degree in Medicine and Surgery, Ain Shams University.

E-mail: hanyzahaby@hotmail.com