LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA

Libro Blanco de las ACES Pediátricas 2024 148 ❚ 4. Recognize alveolar hypoventilation and hypoxemia from blood gas data 5. Recognize metabolic and respiratory acidosis from blood gas data 6. Know the effect of sampling sites on arterial blood gas values in patients with patent ductus arteriosus and right-to-left shunts 7. Recognize changes in arterial blood gas values secondary to hyperventilation due to anxiety 8. Recognize the measurement errors associated with capillary blood gas and venous blood gas tension analysis 9. Recognize various laboratory findings for different causes of hypoxemia 10. Know conditions under which measurements of end-tidal CO2 will correlate poorly with arterial PCO2 (i.e., severe obstructive lung disease) f. Diagnostic criteria 1. Know that chronic respiratory failure occurs in a patient who cannot be weaned after at least 1 month of consistent attempts while medically stable or with an irreversible diagnosis causing respiratory failure (e.g., high spinal cord injury or CCHS) 5. Prevention and therapeutic approach a. Prevention 1. Know which drugs produce central respiratory depression and the treatment for such depression 2. Know which drug interactions predispose patients to respiratory center depression and respiratory failure 3. Know that respiratory failure can be anticipated in children with progressive neuromuscular diseases and that discussions about long- term treatment should be held with families before this occurs 4. Recognize that impairment of airway clearance can occur before respiratory failure in patients with neuromuscular disease 5. Know that impaired airway clearance predisposes towards respiratory failure in patients with neuromuscular weakness b. Therapeutic approach 1. Know the effect of blood transfusion and calculate its impact on oxygen delivery and oxygen content 2. Know the indications for mechanical ventilation in patients with respiratory failure 3. Understand how hyperbaric oxygen therapy might improve oxygen transport to tissues 4. Know how to treat respiratory alkalosis 5. Know the treatment of altitude-induced pulmonary edema 6. Know the oxygen-carrying capacity of hemoglobin 7. Know the differences in goals of mechanical assisted ventilation in children with acute versus chronic respiratory failure c. Side effects of therapy 1. Recognize that mechanical ventilation in the treatment of chronic respiratory acidosis resulting in a rapid fall in PCO2 may lead to alkalosis and seizures 6. Prognosis a. Natural history