This document summarizes key anatomical and physiological differences between neonates and adults that are important for respiratory care. It outlines that neonates have proportionally larger heads, tongues, and airways that can more easily obstruct breathing. Their chests and lungs are also less developed, with fewer alveoli and less ventilatory reserve. Physiologically, neonates have higher metabolic demands and are more susceptible to temperature changes. Understanding these differences is crucial for correctly assessing and treating infant respiratory issues.
This document summarizes key anatomical and physiological differences between neonates and adults that are important for respiratory care. It outlines that neonates have proportionally larger heads, tongues, and airways that can more easily obstruct breathing. Their chests and lungs are also less developed, with fewer alveoli and less ventilatory reserve. Physiologically, neonates have higher metabolic demands and are more susceptible to temperature changes. Understanding these differences is crucial for correctly assessing and treating infant respiratory issues.
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This document summarizes key anatomical and physiological differences between neonates and adults that are important for respiratory care. It outlines that neonates have proportionally larger heads, tongues, and airways that can more easily obstruct breathing. Their chests and lungs are also less developed, with fewer alveoli and less ventilatory reserve. Physiologically, neonates have higher metabolic demands and are more susceptible to temperature changes. Understanding these differences is crucial for correctly assessing and treating infant respiratory issues.
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as PPT, PDF, TXT or read online from Scribd
Respiratory Care Department MSRT411: Perinatal and Pediatric Respiratory Care
Anatomical and Physiological
Differences in Neonates
Ghazi Alotaibi, PhD, RRT
Lec06-Oct03 Are they just a small version of adult? Why is it important to know the differences??
• To correctly assess the infants (physical
assessment). • To correctly administer therapeutic intervention. 2 Types of Differences • Anatomical Differences: • Head • Nares • Tongue • Airways • Chest • Abdomen • Physiological Differences: • Number of Alveoli • Ventilatory Reserve • Metabolic Demand Anatomical Differences HEAD • Larger than adult (in proportion). • Head can easily fall and block the airways. • End result: Desaturation • What is the corrective action? Implication: • If the infant’s respiratory status appears to be compromised - first - reposition the head of the infant before trying more aggressive types of therapy. Surface area of the Head: • Since the infant’s head is proportionally larger than adult: • Surface Area is larger: • More heat loss can occur through the head. NARES • Infants are mostly obligate nose breather (breathe nasally under normal circumstances). • Due to small diameter of nasal passages, secretions and inflammation dramatically increase resistance and WOB. • What changes are observed in Nares with increased respiratory distress?? TONGUE • Proportionally larger than adult (What for?) • The tongue can fall to the back of the pharynx and cause an airway obstruction. • Infants also have a large amount of lymphoid tissue in the area of the pharynx. increase the risk for upper airway obstruction • Implications: • During insertion of oropharyngeal airways. • Can affect stability of ET tube (strong suck reflex of the tongue). AIRWAYS • Epiglottis: proportionally larger, less flexible, more horizontally. • More subjected to trauma. • Larynx: • The narrowest point in the infant airway is the cricoid ring (What is the narrowest point in adult?). • More subjected to upper airway occlusion than adult. • Use uncuffed ETT. • Trachea: • Infant: Length 60 mm, diameter 4 mm. • Adult: Length 120 mm, diameter 20 mm. • Implications: Infants are more severely affected by changes in airway diameter than adults. • More susceptible to increase in WOB. CHEST • At birth, AP diameter is almost equal lateral diameter • Little chest stability b/c ribs and sternum are mostly cartilage. • To increase minute ventilation: Infant tend to increase respiratory rate not VT Tachypnea • Heart is large in proportion to chest diameter, reducing lung capacity. ABDOMEN • Proportionally larger than adult. • So what?? • Pushes diaphragm, limiting lung expansion. • Implication: during CPAP therapy. Physiological Differences ALVEOLI • 50 million at birth (15-20% of adult). • Bad: if part of lung is affected (infection, collapse), gas exchange is significantly impaired. • Good: if damaged (MV), can grow out of the dysfunction. VENTILATORY RESERVE: • Infants have poor ventilatory reserve: a. Difficult to increase VT. b. Decreased number of alveoli. c. Proportionally large heart. d. Proportionally large abdomen. METABOLIC DEMAND • Higher metabolic demand (100 cal/kg as compared to 50 cal/kg in adult). greater oxygen need. • Infants responds to cold stress by shivering, increasing metabolic demand and oxygen consumption. • So, keep infants WARM. Reading Assignment • Kent, p 112-113 • Article by: Fiona Macfarlane (electronic copy will be provided).