Physiological differences between paediatric and adult patients significantly impact anaesthetic management.
Indunil Karunarathna
Respiratory System:Children have proportionally smaller airways compared to adults, making them more prone to airway obstruction. Higher metabolic rates in children result in increased oxygen consumption and carbon dioxide production, requiring careful monitoring and adjustment of ventilation during anaesthesia. Pediatric patients have a higher respiratory rate and lower functional residual capacity, which affects the choice of anaesthetic induction agents and ventilation strategies. Cardiovascular System:Children have a higher cardiac output per body weight compared to adults, which affects drug distribution and clearance rates. Differences in vascular tone and compliance influence hemodynamic responses to anaesthetic agents and surgical stimuli. Neonates and infants are particularly susceptible to changes in preload, afterload, and contractility, requiring close monitoring and precise fluid management during anaesthesia. Renal Function:Renal function matures with age, affecting the metabolism and excretion of anaesthetic drugs. Neonates and infants have lower glomerular filtration rates and reduced renal blood flow compared to older children and adults, leading to slower drug elimination and potential accumulation of metabolites. Central Nervous System:The developing brain in paediatric patients is more susceptible to the effects of anaesthetic agents, necessitating careful titration of drugs to avoid adverse neurodevelopmental outcomes. Differences in cerebral blood flow and intracranial compliance influence the management of intracranial pressure and cerebral perfusion during anaesthesia. Metabolic Rate:Children have higher metabolic rates and lower energy reserves compared to adults, affecting their response to fasting and stress during the perioperative period. Neonates and infants are particularly vulnerable to hypoglycemia and hypothermia, requiring vigilant monitoring and interventions to maintain metabolic homeostasis. Temperature Regulation:Children have a larger body surface area relative to body weight, making them more susceptible to heat loss during anaesthesia. Neonates and infants have limited thermoregulatory mechanisms and are at increased risk of hypothermia, which can have deleterious effects on metabolism, coagulation, and immune function.
Physiological differences between paediatric and adult patients significantly impact anaesthetic management. Here are some key distinctions:
Overall, understanding the physiological differences between paediatric and adult patients is essential for tailoring anaesthetic management to the unique needs of children, ensuring safe and effective perioperative care. Close attention to factors such as airway management, cardiovascular dynamics, drug dosing, fluid management, and temperature regulation is crucial for optimizing outcomes in paediatric anaesthesia.
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