van Hoorn CE, Costerus SA, Lau J, et al. - Via a retrospective cohort study of 101 consecutive neonates undergoing surgical repair of esophageal atresia type C, researchers defined the perioperative courses of vital and metabolic parameters. Intraoperative blood gas analysis data of 72 patients exhibited derangements despite the type of surgery. The median pH-value reduced to 7.21 and a pH-value below 7.20 was observed in 29 patients and in four cases below 7.0, with the lowest value 6.83. The median PaCO₂ reached an upper level of 7.5kPa with 13 cases above 10.0kPa, with a peak value of 25.8kPa. These high PaCO₂ levels varied with the least measured PaCO₂ of the median 5.6 and with the least value of 2.8kPa. The median PaO₂ level led to an upper level of 16.9kPa, in 22 cases above 20.0kPa, with a peak value of 50.0kPa. These high levels varied with the least measured PaO₂ levels of median 8.3kPa and the least PaO₂ value was 4.7 kPa. Thus, open and thoracoscopic correction of esophageal atresia were related to periods of severe metabolic derangements. These events require to be considered for the assessment of esophageal atresia (surgical) care and in the assessment of short- and long-term outcomes.