Abstract
Safe sedation of pediatric patients requires a thorough understanding of the physiological differences between infants, children, adolescents, and adults. Especially in small infants, there is much less margin for any errors in diagnosis and treatment of respiratory or cardiovascular depression during sedation procedures. This chapter will review developmental aspects of respiratory, cardiovascular, central nervous system, renal, hepatic, hematologic, and temperature homeostatic systems, highlighting the differences between children and adults and emphasizing their relevance to sedation procedures in children.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Shaffer TH, Wolfson MR, Panitch HB. Airway structure, function and development in health and disease. Paediatr Anaesth. 2004;14(1):3–14.
O’Rourke PP, Crone RK. The respiratory system. In: Gregory GA, editor. Gregory’s pediatric anesthesia. 2nd ed. New York: Churchill Livingstone; 1989. p. 63–91.
McClain CD, McManus ML. Fluid management. In: Cote CJ, Lerman J, Anderson BJ, editors. Cote and Lerman’s a practice of anesthesia for infants and children. 5th ed. Philadelphia: Elsevier; 2013. p. 161–77.
Sly PD, Collins RA. Physiological basis of respiratory signs and symptoms. Paediatr Respir Rev. 2006;7:84–8.
Smith CA, Nelson NM, editors. The physiology of the newborn infant. 4th ed. Springfield: Charles C. Thomas; 1976, p. 205.
Delivoria-Papadopoulos M, Ronceric NP, Oski FA. Postnatal changes in oxygen transport of premature and sick infants: the role of red cell 2,3 diphosphoglycerate and adult hemoglobin. Pediatr Res. 1971;5:235–40.
Moss TJ. Respiratory consequences of preterm birth. Clin Exp Pharmacol Physiol. 2006;33:280–4.
Firth PG, Haver KE. Essentials of pulmonology. In: Cote CJ, Lerman J, Todres ID, editors. A practice of anesthesia for infants and children. Philadelphia: Saunders-Elsevier; 2009. p. 221–36.
Friedman WF. The intrinsic physiologic properties of the developing heart. Prog Cardiovasc Dis. 1972;15:87–111.
Friedman WF, George BL. Treatment of congestive heart failure by altering loading conditions of the heart. J Pediatr. 1985;106: 697–706.
Eliot RJ, Lam R, Leake RD, et al. Plasma catecholamine concentrations in infants at birth and during the first 48 hours of life. J Pediatr. 1980;96:311.
Romero T, Covell U, Friedman WF. A comparison of pressure-volume relations of the fetal, newborn, and adult heart. Am J Physiol. 1972;222:1285.
Teitel DF, Sisd D, Chin T, et al. Developmental changes in myocardial contractile reserve in the lamb. Pediatr Res. 1985;19:948.
Nassar R, Malouf NN, Kelly MB, et al. Force-pCa relation and troponin T isoforms of rabbit myocardium. Circ Res. 1991;69:1470–5.
Andropoulos DB. Physiology and molecular biology of the developing circulation. In: Andropoulos DB, Stayer SA, Russell IA, Mossad EB, editors. Anesthesia for congenital heart disease. 2nd ed. Oxford: Wiley-Blackwell; 2010. p. 55075.
Rudolph AM, editor. Changes in the circulation after birth. In: Congenital diseases of the heart. Chicago, IL: Year Book Medical; 1974, p. 9.
Baum VC, Palmisano BW. The immature heart and anesthesia. Anesthesiology. 1997;87:1529–48.
Friedman WF, Pool PE, Jacobowitz D, et al. Sympathetic innervation of the developing rabbit heart. Biochemical and histochemical comparisons of fetal, neonatal, and adult myocardium. Circ Res. 1968;23:25–32.
Jacobowitz D, Koelle GB. Histochemical correlations of acetylcholinesterase and catecholamines in post-ganglionic autonomic nerves of the cat, rabbit and guinea pig. J Pharmacol Exp Ther. 1965;148:225–37.
Pagani M, Montano N, Porta A, et al. Relationship between spectral components of cardiovascular variabilities and direct measures of sympathetic nerve activity in humans. Circulation. 1997;95:1441–8.
Constant I, Dubois M, Piat V, Moutard M, et al. Changes in electroencephalogram and autonomic cardiovascular activity during induction of anesthesia with sevoflurane compared with halothane in children. Anesthesiology. 1999;91:1604–15.
Katona PG, Frasz A, Egbert J. Maturation of cardiac control in full-term and preterm infants during sleep. Early Hum Dev. 1980;4:145–59.
Fabiato A, Fabiato F. Calcium induced release of calcium from the sarcoplasmic reticulum of skinned cells from adult human, dog, cat, rabbit, rat, and frog hearts and from fetal and newborn rat ventricles. Ann N Y Acad Sci. 1978;307:491–9.
Rudolph AM. Myocardial growth before and after birth: clinical implications. Acta Paediatr. 2000;89:129–33.
Friesen RH, Wurl JL, Charlton GA. Haemodynamic depression by halothane is age-related in paediatric patients. Paediatr Anaesth. 2000;10:267–72.
Davignon A. ECG standards for children. Pediatr Cardiol. 1980;1:133–52.
Kandt RS, Johnston MV, Goldstein GW. The central nervous system: basic concepts. In: Gregory GA, editor. Pediatric anesthesia. 2nd ed. New York: Churchill-Livingstone; 1989. p. 161–99.
Dobbing J, Sands J. Comparative aspects of the brain growth spurt. Early Hum Dev. 1979;3:79–83.
Loepke AW, Soriano SG. An assessment of the effects of general anesthetics on developing brain structure and neurocognitive function. Anesth Analg. 2008;106:1681–707.
Davidson AJ. Monitoring the anaesthetic depth in children: an update. Curr Opin Anaesthesiol. 2007;20:236–43.
Ghazal EA, Mason LJ, Cote CJ. Preoperative evaluation, premedication, and induction of anesthesia. In: Cote CJ, Lerman J, Anderson BJ, editors. Cote and Lerman’s a practice of anesthesia for infants and children. 5th ed. Philadelphia: Elsevier; 2013. p. 31–63.
Stevens B, Yamada J, Ohlsson A. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev. 2001(4):CD001069. Review. Update in: Cochrane Database Syst Rev. 2004;(3):CD001069.
Dallman PR, Shannon K. Developmental changes in red blood cell production and function. In: Rudolph AM, Hoffman JIE, Rudolph CD, editors. Rudolph’s pediatrics. 20th ed. Stamford: Appleton & Lange; 1996. p. 1167–70.
American Society of Anesthesiologists Committee on Standards and Practice Parameters. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Committee on Standards and Practice Parameters. Anesthesiology. 2011;114:495–511.
Flick R. Clinical complications in pediatric anesthesia. In: Gregory GA, Andropoulos DB, editors. Gregory’s pediatric anesthesia. 5th ed. Oxford: Wiley-Blackwell; 2012. p. 1152–82.
Luginbuehl I, Bissonnette B. Thermal regulation. In: Cote CJ, Lerman J, Todres ID, editors. A practice of anesthesia for infants and children. Philadelphia: Saunders-Elsevier; 2009. p. 557–67.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer Science+Business Media New York
About this chapter
Cite this chapter
Andropoulos, D.B. (2015). Pediatric Physiology: How Does It Differ from Adults?. In: Mason, K. (eds) Pediatric Sedation Outside of the Operating Room. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1390-9_8
Download citation
DOI: https://doi.org/10.1007/978-1-4939-1390-9_8
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4939-1389-3
Online ISBN: 978-1-4939-1390-9
eBook Packages: MedicineMedicine (R0)