Treatment: Preoperative Care Concentrates
Babies with all fistulas, but type H is unlikely to survive without surgical separation and repair of the trachea and esophagus. Surgery can not always be performed immediately because of prematurity, the presence of other birth defects, or complications of aspiration pneumonia. It is usually done in a hospital that has special facilities for the treatment of critically ill newborns. While waiting for surgery, the child's condition is stabilized. Preoperative care concentrates on avoiding aspiration pneumonia and includes: • the elevation of the head to avoid reflux and aspiration of gastric contents • using a suction catheter with mucus and saliva continuously removed that could be inhaled • where appropriate, the placement of a gastrostomy tube feeding withholding • orally when surgery is performed, the esophagus is reconnected to make continuous and separated from the trachea. If both ends of the esophagus are too far apart to be reattached, a piece of tissue from the large intestine is used to assemble the pieces.
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