225. Anesthetic Actions Different From Adults Flashcards
What is the oxygen consumption rate in neonates?
As high as 6 mL/kg-1, roughly twice that of adults.
How does the myocardial structure of the heart differ between neonates and adults?
The myocardial structure is vastly less developed in neonates, leading to a leftward shift of the cardiac function curve.
What compensatory mechanisms do neonates have for increased oxygen requirements?
Presence of fetal hemoglobin and an increase in cardiac output.
What is the effect of immature intercostal and diaphragmatic muscles in neonates?
They do not possess type 1 muscle fibers until approximately 2 years of age, leading to fatigue with increased work of breathing.
What is the main challenge in temperature regulation for infants?
Maintaining normal body temperature is more challenging due to a large ratio of surface to volume and increased metabolism.
At what age does complete maturation of renal function occur in infants?
Around 2 years of age.
How do neonates and infants generally respond to medications?
They respond differently due to their relative size, immature liver and kidneys, differences in extracellular fluid volume, and metabolic rate.
True or False: Full-term neonates require a higher concentration of volatile anesthetics than infants.
False.
What is the reason for the lower dose requirement of intravenous anesthetics in neonates?
An immature blood-brain barrier and decreased ability to metabolize medications.
What is a key consideration when administering neuromuscular blockers to neonates?
They are more sensitive due to immaturity of the hepatic and renal system.
What is the common approach to anesthetic administration for neonates and infants?
Mask inductions are usually used, with intravenous access secured postinduction.
What percentage of neonates experience spells of apnea?
Roughly 20% to 30%.
What is epiglottitis, and what are its classic symptoms?
An inflammatory infection of the epiglottis; classic symptoms include fever, inspiratory stridor, and pain with swallowing.
What is retinopathy of prematurity and its significant risk factor?
Suboptimal vascularization and scarring of retinal vessels; a significant risk factor is prematurity.
What is malignant hyperthermia and its incidence in pediatric cases?
An inherited disease affecting calcium release channels in skeletal muscles; incidence is approximately 1:12,000 in pediatric cases.
