LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA

Libro Blanco de las ACES Pediátricas 2024 154 ❚ a. Know that the amount of aspirated water is relatively small in most drowning victims and that approximately 15% die without aspiration b. Understand the pathogenesis of hypoxemia in near-drowning c. Understand the effect of hypothermia on the interpretation of blood gas values and acid-base status in near-drowning d. Understand the influence of hypothermia on the clinical manifestations associated with near-drowning d. Diagnosis and clinical manifestations 1. History a. Recognize historical factors that portend good outcomes despite near- drowning 2. Physical examination a. Recognize the physical findings associated with near-drowning 3. Imaging a. Know that hypoxemia may precede radiographic changes in near-drowning 4. Pulmonary function tests 5. Other investigations a. Know the electrolyte abnormalities associated with near-drowning 6. Diagnostic criteria 7. Complications e. Prevention and therapeutic approach 1. Prevention 2. Therapeutic approach a. Understand the indications for and applications of supplemental oxygen and positive end-expiratory pressure in the management of near-drowning b. Know that the clinical condition on presentation influences the prognosis with therapy in near-drowning/drowning victims 3. Side effects of therapy f. Prognosis 1. Natural history 2. Prognosis with therapy g. Gastroesophageal reflux 1. Epidemiology 2. Etiology a. Know the effects of increased respiratory work on gastroesophageal reflux b. Know that gastroesophageal reflux is more common in children with neuromuscular disorders and obstructive airway diseases than in healthy children 3. Pathophysiology a. Know that gastroesophageal reflux may be associated with respiratory findings of cough and wheeze in the absence of pulmonary aspiration b. Know that esophageal irritation and distention can produce airway secretions via cholinergic neural reflexes c. Know the physiologic conditions that predispose to gastroesophageal reflux d. Know the pharmacologic agents that lower esophageal sphincter tone and predispose to gastroesophageal reflux