Features
Implications
  • Myocardium less contractile
  • Ventricle is less compliant and less able to generate tension during contraction
  • Limits size of and changes in stroke volume
  • Cardiac output becomes rate dependent
  • Bradycardia associated with reduced cardiac output and in the neonate external compression should be started if the rate is <60 bpm
  • Myocardium less contractile
  • Ventricle is less compliant and less able to generate tension during contraction
  • Limits size of and changes in stroke volume
  • More prone to developing low cardiac output ('cold') shock during sepsis
  • Vagal parasympathetic tone is most dominant
  • Sinus arrhythmia is common
  • Prone to bradycardia with hypoxia, which should should be treated with oxygen and ventilation initially
  • Vagal parasympathetic tone is most dominant
  • Sinus arrhythmia is common
  • Prone to bradycardia with hypoxia, which should should be treated with oxygen and ventilation initially
  • Resting and maximal heart rate values decrease spontaneously with age
  • Age dependent parameters should be targeted during resuscitation
  • Cardiac output is 300-400 ml/kg/min at birth and decreases to 200 ml/kg/min within a few months
  • Age dependent parameters should be targeted during resuscitation
  • Ductus arteriosus contracts in the first few days of life and fibroses within 2-4 weeks
  • Closure is pressure dependent with neonatal pulmonary vasculature reacting to the rise in PaO2 and pH and the fall in PaCO2 at birth
  • Alterations in pressure and in response to hypoxia and acidosis can lead to reversion to the transitional circulation in the first few weeks after birthv