Ventilation/perfusion inequality
Pearls • Gas exchange is optimized when pulmonary perfusion (Q) and alveolar ventilation (V A ) are tightly matched. The fractal design of the lung and gravitational effects on the…
Noninvasive respiratory monitoring and assessment of gas exchange
Pearls • Pulse oximetry is based on the principles that the pulsatile component of the optical absorbance detected from tissue is primarily from arterial blood and that oxyhemoglobin and reduced…
Structure and development of the lower respiratory system
Pearls • Lungs increase in volume from about 250 mL at birth to 6000 mL in the adult. • Each lung lobe is subdivided into 19 bronchopulmonary segments, which receive…
Overview of breathing failure
Pearls • Three pathways to breathing failure are impaired neural control, failure of the muscles of breathing, and dysfunction of the mechanics of breathing. • Dysfunction of the mechanics of…
Structure and development of the upper respiratory system
Pearls • The structures of the upper airway undergo extensive changes from infancy through young adulthood. An understanding of the numerous variations, congenital anomalies, and resulting special vulnerabilities of the…
Physiologic foundations of cardiopulmonary resuscitation
Pearls • Both the cardiac and thoracic pump mechanisms play a role in infants and children during cardiopulmonary resuscitation. Thus, attention to excellent chest compression technique—with an emphasis on “push…
Performance of cardiopulmonary resuscitation in infants and children
Pearls • There are four distinct phases of cardiac arrest and cardiopulmonary resuscitation (CPR): prearrest, no-flow (untreated cardiac arrest), low-flow (CPR), and postarrest. • The most common precipitating event for…
Pediatric cardiopulmonary bypass
Pearls • Cardiopulmonary bypass (CPB), which originated in the mid-twentieth century, was designed to allow for the repair of congenital heart defects. Its history has since been characterized by perpetual…
Cardiac transplantation
Pearls • Most pediatric transplantations are performed for cardiomyopathy or congenital heart disease not amenable to correction or palliation. • Individuals may have a good quality of life following heart…
Critical care after surgery for congenital cardiac disease
Pearls • The neonatal myocardium is less compliant than that of the older child, less tolerant of increases in afterload, and less responsive to increases in preload. A predictable decrease…
