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Review
. 2022 Feb;32(2):108-117.
doi: 10.1111/pan.14362. Epub 2021 Dec 14.

Developmental respiratory physiology

Daniel Trachsel  1 , Thomas O Erb  2 , Jürg Hammer  1 , Britta S von Ungern-Sternberg  3   4   5
Affiliations
Review

Developmental respiratory physiology

Daniel Trachsel et al. Paediatr Anaesth. 2022 Feb.

Abstract

Various developmental aspects of respiratory physiology put infants and young children at an increased risk of respiratory failure, which is associated with a higher rate of critical incidents during anesthesia. The immaturity of control of breathing in infants is reflected by prolonged central apneas and periodic breathing, and an increased risk of apneas after anesthesia. The physiology of the pediatric upper and lower airways is characterized by a higher flow resistance and airway collapsibility. The increased chest wall compliance and reduced gas exchange surface of the lungs reduce the pulmonary oxygen reserve vis-à-vis a higher metabolic oxygen demand, which causes more rapid oxygen desaturation when ventilation is compromised. This review describes the various developmental aspects of respiratory physiology and summarizes anesthetic implications.

Keywords: airway; airway obstruction; child; compliance; control of breathing; growth; physiology.

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Figures

FIGURE 1
FIGURE 1
Model of pulmonary interdependence and elastic recoil forces infants and adults (from ref., copyright Elsevier, with permission)
See this image and copyright information in PMC

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