LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA

Neumología Pediátrica. Anexos ❚ 193 5. Toxicity a. Understand how diuretic therapy may contribute to the development of metabolic alkalosis b. Know the interaction of diuretics and aminoglycosides with respect to eighth nerve toxicity c. Understand the toxicity of chronic diuretic therapy in infants and children G. Chest physiotherapy 1. Indications a. Know that chest physiotherapy is indicated in the treatment of chronic, suppurative lung disease b. Know that chest physiotherapy is not indicated in the treatment of uncomplicated pneumonia 2. Techniques a. Know the various techniques for performing chest physiotherapy (eg, autogenic drainage techniques, positive expiratory pressure, mask, flutter device, high- frequency chest wall oscillations, intrapulmonary percussive devices, etc.) b. Know the role of cough-assist devices in patients with muscular weakness H. Aerosol therapy 1. Factors determining deposition site in the airway a. Understand the relationship between particle size and deposition site in the airway b. Know that gravity, inertia, and Brownian movement are mechanisms contributing to deposition of an aerosol in the airway 2. Types of equipment a. Nebulizer 1. Understand the differences between ultrasonic and jet nebulizers 2. Recognize that in aerosol therapy the majority of medication is not delivered to the lung b. Metered-dose inhaler 1. Know the techniques for maximizing the response of a patient to medication administered by metered-dose inhaler 2. Understand the value of spacer devices in metered-dose inhalers I. Humidification 1. Understand the difference between relative humidity and absolute water content 2. Know techniques for humidifying inspired gas and appreciate the relative efficiency of each 3. Recognize the indications for humidification of inspired gases 4. Recognize the side effects of mist therapy J. Oxygen therapy 1. Delivery systems a. Recognize the differences among various oxygen delivery systems (eg, liquid, compressed gas, concentrator) b. Know that when nasal prongs are used, during the process of inspiration there is a variable and unknown inspired oxygen concentration c. Know the underlying principle of a Venturi valve d. Know which oxygen delivery systems provide a known fraction of inspired oxygen e. Know uses and risks of hyperbaric oxygen therapy for carbon monoxide poisoning