Why are Children at Increased Risk from Airway Obstruction?
There are anatomical, physiological and developmental reasons for children to be particularly susceptible to airway obstruction. The nares, upper and lower airways are smaller in absolute terms in children. Resistance to air-flow (and thus the work of breathing) increases during quiet, laminar flow breathing in inverse proportion to the fourth power of the radius. A small decrease in radius of the airway increases markedly the resistance to breathing. This is even more noticeable during crying when airflow is turbulent as resistance is then related to the fifth power of the radius. An example of this amplification effect in the upset child is to compare the increase in airway resistance when the airway narrows from 4mm to 2mm: in the quiet child the airway resistance increases 16-fold but when the child cries the increase is 32-fold. The infant has a relatively large tongue and the larynx is situated relatively high in the neck, with the epiglottis at the level of C1 at birth, C3 in th
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