LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA

Libro Blanco de las ACES Pediátricas 2024 204 ❚ b. Know the role of nitric oxide in lowering pulmonary vascular resistance 2. Airflow and lung mechanics a. Understand how increased surface tension at the alveolar air-liquid interface can lead to reductions in end-expiratory volume b. Understand the role of laryngeal and respiratory muscle function in maintaining end-expiratory volume above functional residual capacity in neonates and young infants c. Know that surfactant is released from type II cells at birth 3. Gas exchange a. Know the stimuli involved in initiation of respiration (thermal, tactile, chemical, etc.) after birth b. Know changes in arterial blood gas tensions and acid base status during the perinatal period 4. Clearance of lung liquid a. Know that lung liquid clearance takes many hours b. Know pathways of lung liquid removal during and following the birth process c. Understand the mechanisms of lung liquid removal (mechanical, osmotic forces, active sodium transport) during and following the birth process C. Postnatal 1. Structure a. Airways and alveoli 1. Know that continuing alveolarization of terminal bronchioles “transforms" them into respiratory bronchioles 2. Know that new alveoli arise from saccules by the processes of septation and capillary invasion 3. Know that collateral ventilation is poorly developed in newborn infants 4. Know the timing of the greatest increases in alveolar numbers during postnatal life 5. Know that there is no increase in the number of small conducting airways after birth 6. Know that vascular endothelial growth factor is important in lung vasculogenesis b. Pulmonary circulation 1. Understand the association between decreased pulmonary arterial pressure and decreased muscularization of the pulmonary circulation 2. Know that proliferation of new arteries occurs most rapidly in the first one to two years after birth and parallels alveolar multiplication 3. Understand the structural changes of the pulmonary arterial system that occur postnatally 4. Know that there are nonmuscularized pulmonary arteries 5. Know that pulmonary veins increase in number postnatally in association with alveolar multiplication c. Cellular growth 1. Know that neuroepithelial bodies or argyrophil cells are relatively prominent in the lungs of newborn infants, decrease in density during the first year after birth, and increase in infants with bronchopulmonary dysplasia