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Introduction to pediatric
cardiopulmonary physiology.
My name is Hannah
Bellsham-Revell and
I'm a pediatric cardiologist at
Evelina London
Children's Hospital.
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First of all, we're
going to look at
the normal physiology and
anatomy of the heart.
Here you can see the
venous blood return to
the right atrium from
the superior and
inferior caval veins.
Go through the
tricuspid valve into
the right ventricle and then
out the pulmonary
artery to the lungs.
In the lungs, the blood
is oxygenated and
returns via the pulmonary
veins into the left atrium.
Drains through the
mitral valve into
the left ventricle and then is
pumped around the body
through the aorta.
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When we look at normal ranges,
there are differences
between adults and children.
Children generally
breathe faster
and have a higher heart
rate than adults.
There are numerous ranges
available which are normal.
Respiratory rate and heart rate
awake versus asleep may
be different as well.
Oxygen levels should always
be the same in
adults and children
and we usually aim for
oxygen saturations
of more than 95%.
Blood pressure is lower
in children as they are
smaller and again numerous
normal ranges are available.
The key thing is to
know the rough ranges
and know which charts
that you use locally.
For example the
national PEWS System in
the UK is the one that I
will use throughout
these series of talks.
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When considering
the normal ranges
in a baby compared to an adult,
approximate newborn ranges
could be respiratory rates of
40-60 which can be
lower if they're
deeply asleep and higher if
they are crying or active.
Heart rates could be
110-150 which could be down
as 70 if the child is deeply
asleep or up to 200 when crying.
Approximate ranges by adult life
are 15-20 for
respiratory rate which
again can be lower if deeply
asleep but higher if on
exertion or in pain.
The heart rate in adults can be
70-100 and it can be
lower if you're very
fit or deeply asleep and
the maximum heart rate on
exercise is usually around
200 minus your age.
Periodic breathing.
Newborns can breathe
