LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA

Libro Blanco de las ACES Pediátricas 2024 146 ❚ 6. Prognosis a. Natural history b. Prognosis with therapy 1. Know that long-term sequelae (childhood and adult life) of neonatal lung injury (RDS, meconium aspiration, extremely low birth weight, etc.) include airway obstruction, hyperinflation, and airway hyperreactivity 2. Know that some infants with neonatal lung injury develop chronic lung disease of infancy (bronchopulmonary dysplasia) J. Respiratory failure 1. Epidemiology a. Know that death due to respiratory failure is greater in the first year after birth than in any other year of childhood 2. Etiology/genetics a. Recognize the extra-pulmonary causes of respiratory failure (eg, central nervous system injury, severe chest wall deformity, or ventilatory muscle dysfunction) b. Know that pulmonary causes of respiratory failure are due to excessively increased work of breathing and/or severe gas exchange abnormalities 3. Pathophysiology a. Pathology b. Path mechanisms and consequences 1. Know the metabolic compensation for chronic respiratory failure 2. Know the compensatory mechanisms that preserve oxygen delivery to tissues in the presence of chronic hypoxemia 3. Know the consequences of anemia upon oxygen delivery to tissues at rest and during exercise 4. Know the formula for calculating tissue oxygen delivery and its clinical application 5. Know the clinical factors affecting oxygen delivery 6. Recognize the clinical signs of inadequate oxygen delivery 7. Know the clinical consequences of acute hypoxemia 8. Know the clinical consequences of chronic hypoxemia 9. Know the consequences of acute respiratory acidosis 10. Distinguish the physiologic consequences of acute hypercapnia from those of chronic hypercapnia 11. Recognize that hypoventilation may occur during sleep but be absent when awake 12. Know that decreased strength and/or endurance of the diaphragm can cause inspiratory muscle fatigue and respiratory failure 13. Recognize how failure of the respiratory pump affects gas exchange 14. Know that hyperinflation of the lungs puts the diaphragm at a mechanical disadvantage and contributes to respiratory failure 15. Know that hypoxia, hypercapnia, and malnutrition decrease endurance of the diaphragm by decreasing muscle cell energy production, contributing to respiratory failure