This review wants to give an overview to most of the controversial fields in the clinical therapeutic assistance in neonatal and pediatric general and cardiothoracic surgery in anaesthesia and pre or post-operative Intensive Care Unit Treatments. This is a report of the protocols and studies, published or still on the way to be validate, in the Neonatal and Pediatric General and Cardiac Anaesthesia and ICU of a Pediatric Hospital in Bari-Italy. Even though science is very fast in giving to clinicians devices and new therapeutical goals, it is the clinicians themselves who have to use them in a correct way or, at least, in an alternative way, always taking in mind the patient safety. This is how we daily act: we try to adapt the new devices or drugs to the patient’s problems and not the patients to them, keeping in mind that the development of dedicated systems in neonatal and pediatric age is very difficult to reach. In the last few years we have adapted some of the adults techniques to neonate and pediatric patients, after parent’s consent signed, trying to open new pathways in several different pathology treatments and in anesthesia Haemodiafiltration and new blood purification techniques for septic shock and sepsis treatment, use of new procoagulative factors in neonatal cardiac surgery, validation of a new non invasive bio-impedenzometric program and devices for a total control of cardiovascular status applicable to premature and neonate, new miorelaxant and antidote use, sedation in ICU, Pediatric TCI developments, are the targets of our daily work.