ICU Primary PrepCast #Epi 85 - ICU Primary Snippet 28 - Neonatal Physiology Cardiovascular Changes
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Dec 15, 2023 Exploring the transition from blue to pink in newborns, discussing cardiovascular changes like closure of the patent foramen ovale and evolving cardiac output. Delving into hemoglobin transition, liver function, and cardiovascular challenges post-birth. Unpacking newborn cardiovascular and metabolic changes, highlighting sympathetic dominance and metabolic demands for thermoregulation.
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Pulmonary Blood Flow and Oxygenation
- A newborn's transition to independent breathing requires a corresponding increase in pulmonary blood flow to effectively oxygenate the body.
- This transition involves complex cardiovascular changes, including closure of fetal shunts and a decrease in pulmonary vascular resistance.
Cardiovascular Changes at Birth
- A newborn baby's initial oxygen saturation is low (60-65%) due to fetal hemoglobin.
- Umbilical cord contraction reduces venous return, increases systemic vascular resistance, and ultimately closes the foramen ovale.
Cardiac Output and Ventricular Changes
- A newborn's cardiac output is initially high (300 mL/kg/min) but gradually decreases over the first six weeks.
- The right ventricle dominates at birth but the left ventricle grows larger over time.