Anatomical differences between adult and paediatric?

Answer 1

Why Children and Adults are Different Adult physicians often underestimate the differences between adults and children. Those who work with children seldom do. Although children are very different from adults in physiology and disease, we commonly extrapolate data from adult traumatic brain injury (TBI) studies to pediatrics. At best this is often inappropriate; at worst it may be dangerous. The problem is that there are fewer studies in children, and so less evidence on which to base recommendations. Children are seen as a vulnerable population in ethics terms and so extrapolation from adult data is encouraged, which contributes to this practice. Its unintended consequence is weakened evidence to direct treatment for this most vulnerable population. This may be defendable if children were easier to treat than adults but unfortunately the converse is true. All of the difficulties and controversies of adult TBI are compounded in children. There are many examples. In children, the debate about thresholds for intracranial pressure (ICP) treatment are aggravated by the fact that normative values for ICP in children are not well established and depend on age. The same is true for blood pressure (BP), and so uncertainty about optimal cerebral perfusion pressure (CPP) thresholds is even greater. Resting and activated metabolic rates change across the childhood age range before settling into a reasonably stable pattern in adulthood, as does cerebral blood flow (CBF) and its response to injury. Clinical assessment is challenging—there are differences in the expected patterns of injury, clinical evaluation, imaging, and outcome assessment. Differences abound also in surgery: children have smaller blood volumes, reduced tolerance for blood loss, increased risks of long anesthesia, different reactions to medications, and reduced tissue perfusion—these are all challenging in children and so require special knowledge of TBI in childhood to optimize management. And that is not even mentioning the considerable anatomical differences. There can be little debate that children are indeed very different.

Answer 2

As many as possible? key ones?