Age Comsiderations For Anesthesia

Question 1

Compared to adults what are some differences you have to consider for neonates

Answer 1

They have decreased ability to respond to stress, limited organ reserve, need a decreased dose requirement, have an immature sympathetic nervous system (inadequate hypotension-baroreceptor response), increased extracellular fluid (so increased volume distribution of water soluble drugs), higher metabolic rate

Question 2

What is neonate cardiac output dependent on and why

Answer 2

CO is dependent on HR
They have minimal ability to increase contractility
CO = HR*SV (SV is determined by contractility, preload and afterload)

Question 3

What occurs for fetal circulation and needs to be changed when they are birthed (neonate circulation)

Answer 3

• fetal circulation: gas exchange occurs in the placenta (umbilical vein receives oxygenated blood and ductus venous delivers oxygenated blood to the vena cava), they have a high pulmonary vascular resistance as they have non functional lungs, and a RIGHT TO LEFT SHUNT
• detachment from the placenta causes the ductus venous to close and prompts the newborn to take its first breath causing the the foramen ovale and ductus arteries us to close and a decreased pulmonary resistance.