LIFESPAN-neonate Flashcards
When is the neonatal period versus the infant period
neonate = 0-28 days infant = 20 days to 1 year
Normal values for the following in the NEWBORN: SBP= DBP= HR= RR=
SBP= 70 DBP= 40 HR= 140 RR= 40-60
Normal values for the following in the 1-y/o: SBP= DBP= HR= RR=
SBP= 95 DBP= 60 HR= 120 RR= 40
Normal values for the following in the 3-y/o: SBP= DBP= HR= RR=
SBP= 100 DBP= 65 HR= 100 RR= 30
Normal values for the following in the 12-y/o: SBP= DBP= HR= RR=
SBP= 110 DBP= 70 HR= 80 RR= 20
Why is RR so high in the nenonate
B/c O2 consumption and CO2 production are double that in adults
Alveolar ventilation must increase to match the metabolic difference
What variable is the primary determinant of CO in the pediatric pt
HR
Why is SV difficult to adjust in the neonate
The myocardium lacks contractile elements to significantly adjust contractility or SV
At what threshold is HoTN in the following:
Newborn =
1-year =
>1-year =
Newborn = <60 mmHg 1-year = <70 mmHg >1-year = <[70+(age x 2)]
Which medication is preferred for bradycardia in the neonate
Epinephrine
Why is bradycardia a more common response to stress than tachycardia in the neonate
Because the PNS is more mature than the SNS
Describe the baroreceptor reflex development in the neonate
It is poorly developed and it fails to increase HR in the setting of hypovolemia
How does tongue anatomy differ between adults and infants and the anesthetic implication
difference = infant is relatively large
implications =
- more likely to obstruct upper airway
- more difficult to displace during DL
How does neck anatomy differ between adults and infants and the anesthetic implications
Infants have shorter necks
implication = more acute angle required to visualize glottis
How does epiglottis anatomy differ between adults and infants and the anesthetic implications
Adult = leaf or C shape, floppy, short Infant = U shape, stiff, long
Implications = stiff epiglottis is more difficult to displace
How does VC anatomy differ between adults and infants
Adult = perpendicular to trachea Infant = anterior slant
2 Anesthetic implications of infant VC anatomy
- visualization and passage of ETT more difficult
2. ETT can get stuck in anterior commissure
How does laryngeal anatomy differ between adults and infants
Adult = positioned at C5-C6
Infant = positioned at C3-C4
-more superior/cephalad/rostral NOT anterior
Anesthetic implications of infant laryngeal position
- Miller may be preferential over Mac
2. The larynx descends to C4 ~1 yr
When does the pediatric larynx achieve adult positioning
around age 5-6
What is the narrowest portion of the airway in the adult vs infant
Adult = glottis (VC) Infant = Cricoid or glottis
3 Anesthetic implications of narrowest point of infant airway
- resistance to ett beyond VC is likely the cricoid rings
- Cricoid tissue is prone to inflammation and edema (stridor/obstruction)
- Consider Poiseuille’s law, airway radius, and airflow resistance
Compare the subglottic airway shape between adults and infants
adult = cylindrical infant = funnel
Compare the bronchus positions between adults and infants
adult = more vertical (25* off midline) infant = less vertical (55* off midline)
