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This article analyzes related risk factors and literature review from perioperative ventilation, circulation and other aspects of management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A neonate diagnosed as congenital bronchobiliary fistula combined with severe chemical pneumonia, consolidation of the lungs, and infection was facing the risk of anaesthesia under thoracoscopy exploration surgery, who experiened more than 20\u2009days diagnostic period before operation. Many risk factors have led to conversion from minimally invasive surgery to thoracotomy, including persistent hypoxemia, hypercapnia, difficult surgical exposure and extremly difficulty of intraoperative ventilation management. Anesthesia maintenance after conversion to open access remained problematic. Fortunately the patient showed no sign of any adverse CNS effects after 4\u2009months of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The most prominent anesthesia challenges are hypoxemia, increased airway resistance, impaired ventilation, and the risk of metabolic acidosis. Close cooperation among the entire neonatal medical team is the key factors in successful management of this rare case.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12871-020-01052-4","type":"journal-article","created":{"date-parts":[[2020,6,2]],"date-time":"2020-06-02T08:04:34Z","timestamp":1591085074000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Anesthesia management in neonatal congenital bronchobiliary fistula: case report and literature review"],"prefix":"10.1186","volume":"20","author":[{"given":"Hong","family":"Yin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangyi","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingjie","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7311-8136","authenticated-orcid":false,"given":"Ping","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,6,2]]},"reference":[{"issue":"1","key":"1052_CR1","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1016\/j.athoracsur.2008.06.028","volume":"87","author":"A G\u00fcnlemez","year":"2009","unstructured":"G\u00fcnlemez A, Tugay M, Elemen L, T\u00fcrker G, G\u00fcrcan NI, Demir H, G\u00fcrb\u00fcz Y, Hosten T. 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