Unit 1: Pediatric Pulmonary Considerations Flashcards
What time spand do the pulmonary alveoli form in children?
From weeks 25-26 until 8-10 years of age.
At home many weeks gestation does surfactant become mature?
35 weeks gestation
The differences between pediatrics and adults when comparing:
Larynx?
Higher in pediatrics → allows simultaneous breathing and swallowing up to 3-4 months of age.
The differences between pediatrics and adults when comparing:
Alveolar surface area?
Pediatrics have less → adult levels not reached until 8-12 y/o
The differences between pediatrics and adults when comparing:
airway diameter and structural support?
Reduced in infants → greater resistance to airflow → inc work of breathing/greater chance of obstruction.
The differences between pediatrics and adults when comparing:
Rib cage configuration?
Circular in infants (horizontal plane)
- poor mechanical advantage → no bucket handle
Elliptical in adults due to gravity
The differences between pediatrics and adults when comparing:
Diaphragms angle of insertion?
Horizontal in pediatrics due to circular rib shape
The differences between pediatrics and adults when comparing:
Lung compliance?
Dec compliance in pediatrics
- Development of elastic tissue in alveoli → complete after adolescence
- Worse in premies → surfactant not present
In neonates up to three months, have irregular respiratory with bouts of apnea lasting how long?
5-10 seconds.
How long is true apnea in neonates?
Lasts longer than 20 seconds.
The differences between pediatrics and adults when comparing:
Compensation for respiratory difficulties?
Infants inc rate rather than depth of ventilation like adults.
- Infants have little pulmonary reserve.
In infants, what causes increase work of breathing during REM sleep?
Decreased postural muscle tone due to 30% reduction in functional residual capacity (FRC)
- Harder to create a contraction when there is an obstruction
The differences between pediatrics and adults when comparing:
The % Type I of the diaphragm?
Infants 25%
- Premature - little as 10%
Adults 50%
- Reach adult levels at 8 months of age
The differences between pediatrics and adults when comparing:
Smooth muscle in bronchiole walls?
Smooth muscle in bronchioles does not develop until 3-4 y/o
- Inc risk of airway collapse
What are the Pores of Kohn and when do they develop in children?
- Interconnections between Alveoli
- Reach adult levels at 1-2 y/o
**Allow for opitmal airflow in case of obstruction**

What are the Lambert’s Canals and when do they develop in children?
- Connection between terminal or respiratory bronchioles and alveoli
- Develop at 6-8 y/o
**Allow for opitmal airflow in case of obstruction**

When do transplacentally derived antibodies leave infants? What is the result of there absence?
- Gone by 3-4 months of age.
- Infant cannot make own antibodies → defenseless
What are 5 neonatal respiratory control problems?
- Irregular respiration
- Altered respiratory threshold due to inability to temporally and spatially sum signals
- Inability to rapidly increase rate and depth of respirations
- Risk of central apnea
- Difficult to compensate for low O2 and high CO2 due to immature chemoreceptors
For a newborn what is:
- The average HR?
- HR range?
- BP?
- Respiratory Rate?
- Average HR: 120
- HR Range: 70-190
- BP: 40-70?
- Respiratory Rate: 30-60
For a 14 y/o what is:
- The average HR?
- HR range?
- BP?
- Respiratory Rate?
- Average HR: 85
- HR range: 60-100
- BP: SBP: 120-140/DBP:70-85
- Respiratory Rate: 18-22
For an adult what is:
- The average HR?
- HR range?
- BP?
- Respiratory Rate?
- Average HR: 74-76
- HR Range: 60-100
- BP: SBP: 110-140/DBP: 60-80
- Respiratory Rate: 10-20
What are the arterial blood gases (ABG’s) in an adult?
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PaO2 = 100 mmHg partial pressure of oxygen in arterial blood
PaCO2 = 40 mmHg partial pressure of carbon dioxide in arterial blood
PvO2 = 40 mm Hg partial pressure of oxygen in venous blood
PvCO2 = 46 mm Hg partial pressure of carbon dioxide in venous blood
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What are the arterial blood gases (ABG’s) in infants?
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PaO2 = 50-80 mm Hg
PaCO2 = 32-45 mm Hg
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What are the signs or respiratory distress in an infant/toddler?
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Nasal flaring
Head bobbing
Cyanosis
Pallor
Audible expiratory grunting
Stridor on inspiration
Tachypnea
Tachycardia/bradycardia
Fatigue
Excessive sweating
Hypertension/hypotension
Hypoxemia
Hypercapnia
Acidosis
Seizures/coma
Restlessness/irritability
Headache<!--EndFragment-->