Vagal response in peds during ET intubation

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adwilcox28

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Why are vagal stimulation responses more predominant in peds when intubating?
 
For one, it's a lot easier to put pressure on the carotid sheath (which contains the vagus nerve) with the laryngoscope in kids. Also, there are a couple of things about the way the heart of a child operates that make it more prone to responding strongly to vagal stimulation. I'm a couple of beers into the evening and can't recall off the top of my head what the exact mechanism for that is at the moment. Women are also more prone to similar issues as well.
 
I don't think it is fully understood why. I have heard a lot of theories, and some interesting things with the vagus ( both right and left ). Women also seem to be more susceptible too. ( Which I am sure is out there in googly land somewhere )
It probably relates to the protective mechanisms that are so well defined in peds.
 
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