[Anesthesia in neonates and preterm infants : Current knowledge on ventilation, circulation and transfusion].

The survival rate of extremely preterm infants (< 28 weeks of gestation) has substantially improved over the past decades. The earlier an infant is born, the more likely anesthesiological care becomes necessary (62% < 28 weeks gestation vs. 6% in term infants). Anesthesiologists are therefore increasingly involved in the management of this highly vulnerable population of neonates and preterm infants. Intraoperative events requiring intervention, such as hypotension, hypoxemia and anemia, are frequently found, occurring in up to 70% of infants younger than 32 weeks postmenstrual age and markedly increase morbidity and mortality, particularly when they occur in combination. This article reviews the current literature on three outcome-relevant domains in the anesthesiological management of neonates and preterm infants: hemodynamic management, ventilation strategies and transfusion of cellular blood products and outlines approaches by which clinical outcomes can be improved.