Neonatal A&P 2 Flashcards
(51 cards)
During an inhalation induction, a neonate begins to desaturate shortly after the removal of the facemask. Which statement BEST explains why the neonate desaturated so quickly?
a. decreased tidal volume to dead space ratio
b. oxygen consumption is 3 mL/kg/min
c. increased alveolar ventilation to FRC ratio
d. the patient is experiencing malignant hyperthermia
c. increased alveolar ventilation to FRC ratio
What is the oxygen consumption of neonates compared to adults?
higher to support metabolic demand (6 mL/kg/min)
What is the FRC of the neonate?
slightly decreased than the adult which reflects a reduced oxygen reserve
Compared to adults, neonates have an _________________ to increase oxygen supply
increased alveolar ventilation
During hypoventilation or apnea, the neonate’s relatively higher oxygen consumption will
quickly exhaust the oxygen reserve contained in the FRC leading to rapid desaturation
Describe the speed of inhalation inductions for neonates.
faster b/c faster turnover of the FRC allows for speedier development of anesthetic partial pressure inside the alveoli
It is metabolically more efficient for the neonate to increase ___________ rather than ___________
respiratory rate; tidal volume
Alveolar ventilation of the neonate is
130 mL/kg/min
Tidal volume of the neonate is
6 mL/kg
When compared to the adult, select the true statements regarding the pulmonary system in the newborn. (select 2)
a. the diaphragm has more type 1 than type 2 muscle fibers
b. the diaphragm has more type 2 than type 1 muscle fibers
c. the newborn has a higher tidal volume on a per weight basis
d. neonates have the same amount of dead space on a per weight basis
b. the diaphragm has more type 2 than type 1 muscle fibers
d. neonates have the same amount of dead space on a per weight basis
__________ is the primary muscle of inspiration
The diaphragm
Neonates have a lower amount of _____________ muscle fibers which increases the neonate’s risk for
type 1 slow-twitch endurance; respiratory fatigue and developing respiratory failure
Neonates are at risk of _______ following surgery and anesthesia
apnea
______________________ should be admitted for 24 hour observation with an apnea monitor
Patients less than 60 weeks post-conceptual age
The risk of apnea is inversely related to
gestational and post-conceptual age
_______________ may reduce the risk of postoperative apnea after general anesthesia but it does NOT take the place of postoperative admission with apnea monitoring
Prophylactic caffeine (10 mg/kg IV)
______________ is an alternative to caffeine but it carries a higher risk of toxicity
theophylline
________________ have a greater risk of postoperative apnea than infants >44 weeks PCA
Former pre-term infants < 44 weeks PCA
In the neonate, what percentage of respiratory muscles are type-1 fibers?
25% (compared to 55% in adults)
When compared to the adult, which statement presents the MSOT accurate understanding of neonatal pulmonary mechanics? (select 2)
a. airflow resistance during tidal breathing is decreased
b. residual volume is decreased
c. closing capacity is increased
d. chest wall compliance is increased
c. closing capacity is increased
d. chest wall compliance is increased
Compared to the adult, the newborn has _______ lung compliance and __________ chest wall compliance
lower lung compliance and higher chest wall compliance
The lower lung compliance and higher chest wall compliance of the newborn favors
chest wall collapse during inspiration (paradoxical breathing) and reduced lung volumes at expiration
What is the neonates residual volume compared to adults?
higher
What is the neonates closing capacity compared to adults?
higher
