What is included in preoperative care for congenital tracheoesophageal fistula (TEF)?

Updated: Nov 07, 2018
  • Author: Sat Sharma, MD, FRCPC; Chief Editor: Vinay Kumar Kapoor, MBBS, MS, FRCS, FAMS  more...
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Answer

In the preoperative phase, risk of aspiration should be reduced. Continuous suctioning of the blind esophageal pouch with an 8F catheter may decrease the risk of aspiration. The infant's head should be elevated, and he or she should be hydrated and provided energy intake (caloric intake) via intravenous dextrose solution.

If the patient develops acute respiratory failure, endotracheal intubation and mechanical ventilation are performed. Administer broad-spectrum antibiotics for patients who may have developed lower respiratory tract infection. For patients known to have pneumonia or other pulmonary problems, a gastrostomy for gastric decompression may be required to prevent further reflux of gastric contents into the trachea. The use of proton pump inhibitors may be helpful.


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