LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA

Libro Blanco de las ACES Pediátricas 2024 138 ❚ 1. Recognize that asymmetric pectus excavatum may be associated with secondary thoracic scoliosis 5. Prevention and therapeutic approach a. Prevention b. Therapeutic approach 1. Recognize that the primary indication for surgical treatment of pectus deformities is cosmesis 2. Realize that surgical correction of pectus excavatum deformity is not associated with significant improvement in pulmonary function 3. Recognize that in a small number of patients with pectus excavatum, exercise tolerance is limited by the inability to increase tidal volume at maximal exercise workload 4. Know that moderate pectus excavatum does not cause symptoms at rest or on exercise c. Side effects of therapy 1. Know that too early or too extensive a repair of pectus excavatum can result in failure of chest wall growth and development of acquired asphyxiating thoracic dystrophy 6. Prognosis a. Natural History 1. Recognize that a pectus excavatum deformity may worsen with growth b. Prognosis with therapy 1. Recognize that recurrence of a pectus excavatum is possible following surgical repair, especially in children with Marfan syndrome c. Diaphragm 1. Epidemiology 2. Etiology/genetics a. Recognize birth factors and/or surgical procedures that may lead to diaphragmatic paralysis 3. Pathophysiology a. Pathology b. Path mechanisms and consequences 1. Know that eventration of the diaphragm can result from diaphragmatic maldevelopment 2. Know that unilateral diaphragmatic weakness is most problematic in early infancy due to the nature of the rib cage (position and compliance) 4. Diagnosis and clinical manifestations a. History 1. Recognize that diaphragmatic eventration is included in the differential diagnosis of severe respiratory distress in newborn infants 2. Recognize that diaphragmatic eventration can be associated with breech or face presentation or difficult forceps extraction during delivery b. Physical examination 1. Recognize the physical findings associated with diaphragmatic eventration