LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA

Libro Blanco de las ACES Pediátricas 2024 216 ❚ k. Know the pathophysiology of conditions leading to increases in alveolar dead 3. Ventilation-perfusion relationships in the lung a. Functional significance 1. Know that V/Q mismatching is the most common reason for hypoxemia in patients with lung disease 2. Understand how V/Q mismatching can lead to hypercapnia in addition to hypoxemia in the absence of compensatory hyperventilation b. Effect of gravity on gas distribution 1. Recognize the factors that affect gas distribution within the lung 2. Understand how change in body position (from supine to standing) alters ventilation-perfusion matching in healthy humans 3. Understand how gravity affects the regional size of pulmonary structures and the regional minute ventilation within the lung c. Effect of gravity on pulmonary circulation 1. Know the effect of gravity on the regional distribution of pulmonary flow d. Effect of gravity on ventilation/perfusion 1. Understand the effect of gravity on regional ventilation/perfusion ratio 2. Understand the effect of gravity on regional PA02 and PAC02 4. Oxygen consumption and carbon dioxide production a. Measuring oxygen consumption and carbon dioxide production 1. Know how to measure and calculate oxygen consumption by expired gas analysis during rest or exercise 2. Know how to measure and calculate CO2 production by expired gas analysis during rest or exercise b. Respiratory exchange ratio 1. Recognize the clinical features that increase oxygen consumption and carbon dioxide production in children 2. Understand that acute hyperventilation (anxiety) can increase the respiratory exchange ratio c. Influence of carbohydrate, fat, and protein 1. Know the respiratory quotient of fat, carbohydrate, and protein 2. Know that carbohydrate ingestion is associated with an increased respiratory quotient secondary to increased CO2 production 5. Alveolar air equation a. (PAO2-PaO2) difference 1. Calculate how a difference in barometric pressure affects arterial PO2 2. Calculate each of the factors in the alveolar air equation 3. Know that normal values for the (PAO2-PaO2) difference change with the fraction of inspired oxygen in healthy individuals 4. Know the definition of alveolar ventilation 5. Know the conditions associated with an increased a-A PO2 6. Know the approximate reduction in alveolar partial pressure of oxygen with increases in altitude in the absence of hyperventilation (i.e., 5 mm Hg per 1000 feet ascent) 7. Know that even pressurized commercial aircraft have cabin pressures compatible with altitudes of approximately 8000 feet and be able to estimate the