SyllabusThe subject will cover the following topics: The syllabus will cover the following topics:
Module 1: Blood gas analysis
* physiologic basis: hypoventilation, heterogeneity of ventilation (V) and perfusion (Q), V/Q mismatch.
* clinical measurement: calibration and minimum equipment specifications, sample procurement, normal ranges.
* quality control issues.
* tests of respiratory function employing blood gas determination: ideal alveolar gas equation, pulmonary shunt, anatomical shunt, Bohr equation.
* arterial blood gas interpretation; oxygen therapy, assisted ventilation.
* noninvasive estimates of blood gases: oximetry, capnography, transcutaneous monitors, expired gas analysis.
Module 2: Distribution of ventilation and perfusion
* physiological basis: anatomical, alveolar and physiological dead space; closing volume, closing capacity, pulmonary perfusion, anatomical shunt, physiological shunt and ventilation-perfusion matching.
* clinical measurement: single breath nitrogen (Fowler's method) and multiple breath nitrogen washout tests
* calibration and minimum equipment specifications; gas analysers, volume and flow meters, pulmonary artery catheters and plethysmographs.
* minimum patient performance criteria, prediction equations and quality control issues.
Module 3: Challenge tests
*physiologic basis: bronchial hypersensitivity, hyper-reactivity and hyper-responsiveness.
* challeng protocol: direct (histamine and methacholine) and indirect (cold/dry/isocapnic hyperventilation, exercise, osmotic - hypertonic saline and mannitol), nebulisers
* clinical measurement: calibration and minimum equipment specifications, airflow limitation indices, dosage (cumulative dose versus concentration)
* quality control issues
Module 4: Exercise testing
* physiologic basis: cardiorespiratory regulation and response to exercise.
* interpretation: cardiorespiratory indices.
Module 5: Sleep disordered breathing
* physiologic basis: respiratory control, sleep staging, inspiratory flow limitation.
* interpretation: EEG, ECG, EMG data, sleep disturbance, apnoea/hypopnea index.
* assisted ventilation therapy: CPAP, PEEP |
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