By Giovanni Ruggeri, Francesco Fascetti-Leon, Giulio Gregori, Mario Lima (auth.), Mario Lima (eds.)
The fresh common software of minimally invasive options has had a profound influence at the prognosis and treatment of thoracic problems, together with within the pediatric age crew. This booklet is meant as a pragmatic advisor to the present methods in pediatric thoracic surgical procedure. up to date details is equipped at the surgical suggestions hired for prognosis and remedy in quite a lot of congenital and bought thoracic pathologies from the prenatal age to youth. one of the issues thought of intimately are cystic malformations of the lung, chest wall deformities, diaphragmatic hernias, esophageal anomalies, mediastinal tumors, laryngeal anomalies, and thoracic infections. The authors are exotic specialists within the box from internationally. Pediatric Thoracic Surgery can be of worth not just for pediatric thoracic surgeons but additionally for grownup thoracic surgeons, pediatric anesthetists, and pediatric respiration physicians.
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Extra resources for Pediatric Thoracic Surgery
The induction of anesthesia decreases the FRC in both lungs, but certainly to a greater extent in the lower lung due to the weight of mediastinal and abdominal contents. The loss of FRC results in a decrease in compliance. This condition shifts ventilation away from the dependent lung to the upper, non-dependent lung. If the child is given neuromuscular blocking agents and submitted to mechanical ventilation, the muscular advantage of the dependent diaphragm is also eliminated, which subsequently favors the redistribution of ventilation in the upper lung.
6 Ultrasound (a) and echo-color Doppler (b) of the lung showing a mediastinal mass These subsequent revisions add value to the axial images, allowing more accurate and reliable diagnostic evaluations in a high percentage of cases . The paucity of visceral fat and difficulty in acquiring images marred by motion artifacts makes the acquisition of good-quality images problematic, thereby complicating recognition of normal structures and certain types of diseases. With respect to motion artifacts, subjects aged <3 years are usually sedated, whereas those aged >5 years can undergo CT if made to feel comfortable with verbal assurances and use of toys.
A large mass is usually seen at around mid-gestation, decreases in size in the third trimester, and infants are usually asymptomatic at birth. Intact survival is the rule with the exception of those cases that develop intrauterine hydrops (which tend to be slightly more frequent than with CCAMs). Amelioration of hydrops with thoraco–amniotic shunting is possible, and in several cases we have been able to continue the pregnancy for several weeks. In the absence of hydrops, vaginal delivery at term is possible.