Neonates Flashcards
(35 cards)
What is the age range for neonates?
up to 4 weeks
CCM: 0-2 neonates, 2wks -6 mo pediatric
What are the 3 bypassing vascular structures in the fetal circulation?
- foramen ovale LA-RA
- ductus arteriosis PA-Ao
- ductus venosus (umbilical vein-caudal vena cava
What percentage of CO is directed to the placenta versus lungs in fetuses?
40-50% to placenta
10-12% to lungs
What hormone plays a key role in keeping the ductus arteriosus patent?
fetal prostaglandin
What causes pulmonary vasoconstriction in fetuses?
- hypoxia
- endothelin
- thromboxane A2
List stimulants for surfactant production
- glucocorticoids
- thyroid hormones
- prolactin
- thyrotropin releasing hormone (TRH)
- catecholamines
- estrogens
How does neonatal renal function compare to adults?
- decreased GFR
- decreased concentrating ability
- altered tubular function
What is the normal USG in neonates?
hyposthenuric
How is the total body water different in neonates?
higher
What is the RR after birth?
15/min initially
increases to 30/min within 1-3 hours
Describe blood count differences in the neonate and pediatric patient
Puppies
* birth Hct 48%
* 30% by 4 weeks»_space; starts to increase again
Kittens
* nadir of 27% at 4-6 weeks
Leukocytosis 1-2 mo (mild to moderate)
Describe neonatal and pediatric chemistry changes
- mild hyperbilirubinemia
- high ALKP (more dramatic in dogs than cats)
- high GGT
- low BUN/creatinine
- high Ca, P
- low albumin and TP
How do neonatal/pediatric thoracic radiographs differ from adults?
- thymus
- heart appears enlarged
- higher pulmonary water content - more radiopaque
- lack of costochondral mineralization
What is a normal MAP and CVP in 1 month or 9 months old puppies?
1 months
* MAP 49 mm Hg
* CVP 8 cm H2O
9 months
* MAP 94 mm Hg
* CVP 2 cm H2O
List reasons for higher fluid requirements in neonates
- higher body surface area ratio
- higher percentage of total body water
- inability to sufficiently concentrate urine
- higher metabolic rate
- more permeable skin
- less body fat
What puts neonates at risk for hypoglycemia?
- inefficient gluconeogenesis
- inadequate hepatic glycogen stores
- glucosuria
- ineffcicient counterregulatory hormones released during hypoglycemia
What energy substrate do fetal and neonatal hearts primarily use?
glucose
as opposed to long-chain fatty acids in adults myocardium
Why is the neonatal heart less efficient at increasing cardiac contractility and HR during hypovolemia?
smaller portion of heart is contractile elements (30%) compared to adults (60%)
immature sympathetic nerve fibers - less efficient at increasing HR in response
At what age does the autonomic nervous system reach maturation?
8 weeks
What USG indicates dehydration in a 4 week old puppy?
> 1.020
At what age do neonates become able to shiver?
6 days
At what age does the gag reflex develop?
10 days
What percentage of bodyweight should puppies gain each day?
5-10 %
should double their weight within 8-12 weeks (same in kittens, should also gain 10-15 g per day)
At what age can pediatric patients sufficiently concentrate urine?
around 10 weeks
