Ashcraft's Pediatric Surgery, 5th Edition - download pdf or read online

By George W. Holcomb III MD, J. Patrick Murphy MD

ISBN-10: 1416061274

ISBN-13: 9781416061274

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Extra resources for Ashcraft's Pediatric Surgery, 5th Edition

Example text

36 Orally administered stable isotopes of water (2H2O and H218O) mix with the body water, and the 18O is lost from the body as both water and CO2, while the 2H is lost from the body only as water. 37 In general, any increase in energy expenditure during illness or after surgery is variable. Recent studies suggest that the increase is far less than originally hypothesized. 43 Effective anesthetic and analgesic management may play a significant role in muting the stress response of the neonate. 44 Low-stress infants do not manifest any increase in energy expenditures during the course of illness.

Their energy requirements show individual variation and are dependent on severity of injury. For instance, an infant with respiratory distress on pressure support is likely to have a high energy requirement owing to increased work of breathing. The same patient, when started on mechanical ventilation with muscle relaxants, is unlikely to have sustained high energy requirements. Infants with congenital diaphragmatic hernia on extracorporeal membrane oxygenation (ECMO) support have been shown to have energy expenditures of approximately 90 kcal/kg/day.

This effect is independent of β-agonist stimulation and, in fact, may act synergistically with a β agonist to improve cardiac performance. Milrinone increases cardiac index and oxygen delivery without affecting heart rate, blood pressure, or pulmonary wedge pressure. 0 μg/kg/min. Septic Shock Afterload represents the force against which the left ventricle must contract to eject blood. It is related to systemic vascular resistance and myocardial wall stress. Systemic vascular resistance is defined as the systemic mean arterial blood pressure minus right arterial pressure divided by cardiac output.

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Ashcraft's Pediatric Surgery, 5th Edition by George W. Holcomb III MD, J. Patrick Murphy MD


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