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Related Concept Videos

Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

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Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

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Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
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When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
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Life's biochemical processes occur within aqueous solutions. Solutes are substances that are dissolved within these solutions. The human body contains a variety of solutes, which can differ across various body parts. These can encompass proteins—such as those responsible for clotting and carbohydrate transport—as well as electrolytes. In medicine, an electrolyte is often described as a mineral ion derived from a salt possessing an electric charge. Examples include sodium ions...
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Author Spotlight: Exploring Venous Waveforms in Porcine Models to Tackle Volume Overload in Medicine
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Fluid responsiveness in the pediatric population.

Ji-Hyun Lee1, Eun-Hee Kim1, Young-Eun Jang1

  • 1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Korean Journal of Anesthesiology
|October 9, 2019
PubMed
Summary

Predicting fluid responsiveness in children is difficult. Noninvasive, flow-dependent variables, particularly respiratory variation of aortic blood flow peak velocity, show promise for guiding fluid administration in pediatric patients.

Keywords:
Blood pressureCardiac outputChildrenDoppler ultrasonographyFluid therapyHemodynamic monitoringOximetry

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Area of Science:

  • Pediatric Critical Care Medicine
  • Hemodynamics
  • Fluid Management

Background:

  • Predicting fluid responsiveness is challenging in pediatric patients.
  • Previous methods using pressure, plethysmography, ultrasonography, and bioreactance have limitations.
  • The pediatric population has unique anatomic and physiologic characteristics compared to adults.

Purpose of the Study:

  • To review potential variables for predicting fluid responsiveness in children.
  • To highlight the advantages of noninvasive, flow-dependent variables over invasive, pressure-dependent ones.
  • To discuss considerations for future pediatric fluid responsiveness research.

Main Methods:

  • Review of existing literature on fluid responsiveness prediction in pediatrics.
  • Analysis of various noninvasive and invasive monitoring techniques.
  • Comparison of variable performance in pediatric versus adult populations.

Main Results:

  • Respiratory variation of aortic blood flow peak velocity is a consistently predictive variable in children.
  • Noninvasive, flow- or volume-dependent variables are more promising for pediatric fluid responsiveness.
  • Significant differences exist in pediatric versus adult physiology impacting fluid responsiveness prediction.

Conclusions:

  • Accurate prediction of fluid responsiveness in children requires careful consideration of unique pediatric physiology.
  • Noninvasive, flow-based metrics offer a promising avenue for guiding fluid therapy in pediatric critical care.
  • Further research is needed to optimize fluid management strategies in pediatric populations.