pedsGrowthAndDevelopmentJan05

pedsGrowthAndDevelopmentJan05 - Pediatric Fundamentals...

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Pediatric Fundamentals Growth and Development Drs. Greg and Joy Loy Gordon January 2005
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Pediatric Fundamentals - Growth and Development Maturational change in form and function Prenatal Growth Gestational age (wks) Mean birth wt (Gm) 25 850 28 1000 30 1400 33 1900 37 2900 40 3500 Postnatal Growth Birth weight doubles by 5 months triples by 1 year Birth length doubles by 4 years
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Pediatric Fundamentals - Growth and Development Maturational change in form and function Percent body water Term newborn 80 1 year old 70 Adult 60 Surface area:Weight premature > full term > infant > child greater surface area greater evaporative heat loss rapid hypothermia if unprotected Girls Boys Puberty onset 11 years 11½ years Peak growth Tanner stage 3 Tanner stage 4
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Pediatric Fundamentals - Growth and Development Metabolism of one calorie of energy consumes one ml of H 2 O, so fluid requirements thought to reflect caloric requirement: Body weight (kg) Calories needed (kcal/kg/day) = Fluid requirement (ml/kg/day) 0-10 100 10-20 1000 + 50/(kg>10) > 20 1500 + 20/(kg>20) Dividing by 24 (hours/day) yields the famous 4:2:1 Rule for hourly maintenance fluid: 4 ml/kg/hr 1 st 10 kg + 2 ml/kg/hr 2 nd 10 kg + 1 ml/kg/hr for each kg > 20 Fluid requirements
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Pediatric Fundamentals - Growth and Development Airway/respiratory system Gas exchange first possible approximately 24 weeks gestation Surfactant production appears by approximately 27 weeks produced of Type II pneumocytes exogenous form available Number (and size) of alveoli increase to age 8 years (size only after 8 years) First breaths of air pneumothorax or pneumomediastinum less than 1% several hours to reach normal lower lung fluid levels
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pedsGrowthAndDevelopmentJan05 - Pediatric Fundamentals...

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