The management of the pediatric surgical patient has received considerable emphasis in recent years. Surgeons are becoming increasingly aware of the fact that special techniques and methods of care that differ in degree and in kind from those in common use in the care of adult patients are necessary in these younger patients. Perhaps not so well appreciated is the fact that the infant or child who undergoes a thoracic surgical procedure presents certain distinct problems in management that are not encountered in adult patients. It is the purpose of this paper to reemphasize some of these special problems and to outline the management we have found useful.
Consideration of the physiology of respiration in the newborn infant raises several problems. Transition from the intrauterine to the normal extrauterine state is a gradual one as far as the lungs are concerned. The "atelectatic" lung of the intrauterine stage does not