New PDF release: Operative Pediatric Surgery 6Ed

By Lewis Spitz, Arnold Coran

ISBN-10: 0751401579

ISBN-13: 9780751401578

The 6th version of this acclaimed operative atlas maintains to supply a distinct point of finished aspect at the complete variety of stipulations provided in early life, together with the fetus and neonate, that may be handled via surgical capability. All chapters were completely revised and up-to-date all through with new line diagrams the place valuable. additionally touching upon symptoms, problems and non-operative administration, Operative Pedaitric Surgery continues to be the pre-eminent operative advisor to a whole variety of paediatric stipulations.

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Additional resources for Operative Pediatric Surgery 6Ed

Sample text

The mean cord hemoglobin concentration is approximately 18 g/dL at birth and rises by 1–2 g/dL in the first days of life because of low fluid intake and a decrease in extracellular fluid volume. 4) and causes the physiologic anemia of infancy. Premature babies have a greater fall because of lower red cell production and survival. At birth, 70 percent of the hemoglobin is HbF, which has a greater affinity for oxygen, possibly because of a relative insensitivity to 2,3-diphosphoglycerate, which itself lowers the oxygen affinity of the hemoglobin molecule.

After birth, an eight-fold increase in the number of alveoli occurs and the adult number is reached by the age of 6 years. The resistance of the airways (and thus the work of breathing) remains high, until finally, the airways begin to enlarge; this occurs at the same time as the full complement of alveoli is present. Closing volume occurs within tidal breathing until 6 years of life, so there is an increase in physiologic right-to-left shunt during this period, with an even greater effect on oxygenation should the FRC fall, as it does with pulmonary disease or during anesthesia.

The liability of the pulmonary vasculature is caused by abundant arteriolar smooth muscle, extending more peripherally than in later life (due to a failure of normal regression of the muscle in the first few hours of life). These arterioles constrict in response to hypoxia, hypercapnia, or acidosis via an adrenergic mechanism (this response is abolished after sympathectomy). Some infants develop this state of persistent pulmonary hypertension of the neonate following a rise in pulmonary vascular resistance and a right-to-left shunt through the ductus arteriosus or patent foramen ovale.

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Operative Pediatric Surgery 6Ed by Lewis Spitz, Arnold Coran


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