LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA

Libro Blanco de las ACES Pediátricas 2024 194 ❚ f. Understand the relative advantages and disadvantages of oxygen delivery via nasal prongs, face mask, blow by, and tent g. Know that the gas flow at the end of a length of tubing attached to an oxygen source is independent of the length of the tubing h. Know the limits of using an oxygen concentrator (ie, high-flow) 2. Indications a. Recognize clinical indications for oxygen therapy b. Know the differences between oxygen saturation, oxygen content, and oxygen partial pressure c. Recognize the cyanotic conditions that will not respond to oxygen therapy d. Recognize the indications for oxygen therapy during air travel in patents with lung disease 3. Monitoring systemic oxygenation a. Know the principles underlying pulse oximetry b. Know factors that influence the accuracy of pulse oximetry c. Know technical factors that may alter the reading of oxygen saturation (eg, fetal hemoglobin, carbon monoxide, methemoglobin) d. Understand the usefulness and limitations of determination of the mixed venous oxygen content e. Know that oximeters require adequate tissue perfusion/blood flow before oxygen saturation can be accurately assessed f. Understand the limitations of transcutaneous PO2 electrodes g. Understand the effect of increased PaO2 on mixed venous PO2 h. Understand the conditions under which capillary PO2 does not accurately reflect arterial PO2 4. Toxicity/side effects of oxygen therapy a. Know the appropriate amount of oxygen to administer to a patient in chronic respiratory failure b. Recognize the adverse effects of oxygen on the various pulmonary cells c. Understand the major cellular antioxidant systems d. Understand the effect of fetal lung maturation or previous oxygen exposure on cellular antioxidant enzyme systems e. Recognize the clinical sequence of symptoms due to oxygen toxicity f. Know that it is the arterial PO2 that is important in the pathogenesis of retinopathy of prematurity, whereas it is the alveolar PO2 that is important in the pathogenesis of lung oxygen toxicity g. Know that the time of onset of oxygen toxicity is proportional to the alveolar PO2 (eg, normobaric versus hyperbaric oxygen) h. Know the mechanism by which oxygen promotes atelectasis 5. Strategies to prevent oxygen toxicity K. Mechanical ventilation 1. Indications for use a. Recognize the indications for mechanical ventilation in various clinical situations b. Recognize the indications for discontinuing mechanical ventilation in various clinical situations c. Know approaches to weaning from mechanical ventilation