Children are not small adults, and this fact is particularly true when
we consider the respiratory tract. The anatomic peculiarities of the
upper airway make infants preferential nasal breather between 2 and 6
months of life. The paediatric larynx has a more complex shape than
previously believed, with the narrowest point located anatomically at
the subglottic level and functionally at the cricoid cartilage.
Alveolarization of the distal airways starts conventionally at 36-37
weeks, but occurs mainly after birth, continuing until adolescence. The
paediatric chest wall has unique features that are particularly
pronounced in infants. Neonates, infants and toddlers have a higher
metabolic rate, and consequently, their oxygen consumption at rest is
more than double that of adults. The main anatomical and functional
differences between paediatric and adult airways contribute to
understanding of various respiratory symptoms and disease conditions in
childhood. Knowing the peculiarities of paediatric airways is helpful in
the prevention, management and treatment of acute and chronic diseases
of the respiratory tract. Developmental modifications in the structure
of the respiratory tract, in addition to immunological and neurological
maturation, should be taken into consideration during childhood.