"Gastroschisis is a neonatal emergency where a small baby meets a big problem: exposed bowel bleeding heat and fluid into the air, and an abdominal cavity too small to take its own contents. The anaesthetist protects the viscera, resuscitates the neonate, and helps decide how much can safely be pushed back inside."
How to use this topic — CritCare.in.Anaesthesia for the Neonate with Gastroschisis
- A preterm/SGA neonate with exposed bowel → massive heat & fluid loss, hypothermia, hypoglycaemia and hypovolaemia. Cover the bowel, decompress the stomach, resuscitate, keep warm, then anaesthetise with a rapid-sequence induction (avoid N₂O) — and match the abdominal closure to the pressure the baby can tolerate, staging with a silo to prevent abdominal compartment syndrome.
Gastroschisis vs Omphalocele
The two abdominal-wall defects contrasted (sac vs no sac, associated anomalies), and why gastroschisis is an urgent problem.
📋02 · PRE-OPNeonatal Resuscitation & Prep
Prematurity/SGA physiology, hypothermia/hypoglycaemia, bowel protection, NG decompression, fluid resuscitation and screening for anomalies.
💉03 · INTRA-OPInduction, Fluids & Monitoring
RSI, avoid N₂O, atracurium, third-space fluid replacement, blood & FFP, and invasive monitoring in a tiny patient.
🎈04 · CLOSURE & ACSPrimary vs Staged & Compartment Syndrome
Primary vs staged silo closure, the pressure criteria that force staging, and abdominal compartment syndrome.
🎓05 · PEARLSRecovery, Mistakes & References
Post-op ventilation, complications (NEC, sepsis), common mistakes, exam pearls and references.