THE young infant has much less respiratory reserve than older children and adults; for example, his resting oxygen consumption, per unit of body weight, is twice that of the adult, 7 ml/kg/min compared with 3-5 ml/kg/min. The diameters of distal airways remain constant from birth until about 5 years of age and only then increase in size (Hogg et al., 1970). Consequently, infants and young children have a high peripheral airways resistance and a greater tendency to airways occlusion than older children. The average newborn infant has about twice the surface for heat loss for each kilogram of tissue compared with the average adult (Cross, 1965). If the infant is placed in a cool environment his metabolism increases to attempt to maintain his body temperature. This increase in metabolism in turn increases his oxygen consumption and minute volume. Nursing an infant in a cool environment places an additional demand on the respiratory system. In an infant already in respiratory distress this could result in respiratory insufficiency. The importance of conserving heat in the care of ill infants is therefore of the utmost importance. In infants, as in adults, the cause of respiratory insufficiency may be decreased respiratory movements or pulmonary complications or a combination of both. For the reasons given above, however, infants will reach a state of respiratory insufficiency more readily than older children.

https://pmj.bmj.com/content/postgradmedj/48/562/507.full.pdf

Artificial ventilation, prolonged endotracheal intubation and tracheostomy in paediatric surgery.

A review of ultrasonic nebulization.

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A review of ultrasonic nebulization.