The metabolic response to surgery in neonates.

Over the past 35 years, surgery-associated mortality in the neonate has declined from greater than 60% to less than 10%. This progress is attributable, almost entirely, to a better understanding of the pathophysiologic changes that can occur during the perioperative period. It is increasingly apparent that the acute metabolic response to injury plays a central role in determining the clinical outcome of the critically ill infant. This article highlights recent developments as they relate to the infant response to acute injury and to show how this knowledge might be used to improve the care of these patients.