LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA
Libro Blanco de las ACES Pediátricas 2024 226 ❚ e. Recognize that the normal ventilatory response to hypoxia is an exponential function of PaCO2 and a linear function of SaO2 3. Abnormal response 12. Pulmonary Vascular Physiology A. Pulmonary vascular physiology 1. Recognize the effect of lung volume on pulmonary vascular resistance 2. Know the physiologic determinants of Zone I, II, and III conditions in the lung 3. Describe the physiologic changes in pulmonary circulation that occur at birth 4. Recognize the factors that cause vasodilation and vasoconstriction of the pulmonary vasculature 5. Describe the normal transvascular fluid flow within the lung 6. Understand the effects of body position (ie, standing versus recumbent) on distribution of pulmonary blood flow 7. Understand how hypoxic pulmonary vasoconstriction is modified by pH 8. Know that hypoxic pulmonary vasoconstriction is not linearly related to alveolar PO2, with increased constriction developing with a PaO2 below 60 mm Hg 9. Recognize the factors that cause pulmonary vasoconstriction 10. Recognize the factors that dictate pulmonary artery pressure 11. Recognize the changes that occur in the pulmonary circulation with exercise 12. Understand where nitric oxide is produced and how it affects pulmonary vascular tone 13. Understand why inhaled nitric oxide may be effective in improving oxygenation and lowering pulmonary vascular resistance in patients with acute respiratory distress syndrome 14. Know that the pulmonary vascular system is a low-resistance, low-pressure, high- compliance vascular bed 15. Describe the influence of alveolar surface tension on transvascular fluid balance 16. Recognize the changes that occur in the pulmonary circulation in an atelectatic lobe and their impact on the time course of related arterial hypoxemia 17. Describe the factors affecting transvascular fluid flow within the lung B. Bronchial vascular physiology 1. Physiology of bronchial circulation a. Understand the factors that influence blood flow through the bronchial vasculature b. Understand the effect of vasoactive compounds on the bronchial vasculature c. Understand how chronic lung inflammation due to bronchiectasis may lead to bronchial artery hypertrophy with subsequent hemoptysis 13. Mechanisms of Lung Inflammation, Injury and Repair A. Pulmonary inflammation 1. Components of an inflammatory response a. Vasodilation 1. Know that vasodilation is one of the components of an acute inflammatory reaction b. Altered permeability 1. Know the relative permeability of endothelium (as compared with epithelium) in the alveoli during acute inflammatory processes c. Leukocytic infiltration 1. Acute
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