The recording of the inaugural session of the WFPICCS Pediatric Respiratory Critical Care Series (PRCCS) is now available to watch:
https://wfpiccs.org/event/breath-by-breath-the-real-science-of-gas-exchange/
This foundational webinar provides a clear, physiology-based exploration of gas exchange in critically ill children, with direct relevance to everyday practice in the pediatric intensive care unit (PICU).
The session is delivered by Martin Kneyber, Chief of the Division of Pediatric Critical Care Medicine at Beatrix Children’s Hospital, University Medical Center Groningen, The Netherlands.
The lecture guides participants step by step through the mechanisms of oxygen and carbon dioxide exchange – from alveolar ventilation and diffusion to ventilation–perfusion (V/Q) matching and tissue oxygen delivery. Using practical bedside examples, the session clearly distinguishes hypoxemia from hypoxia and reviews the major causes of impaired gas exchange, including hypoventilation, shunt, diffusion limitation, and V/Q mismatch.
A significant portion of the webinar focuses on translating physiology into ventilator management. Key concepts such as lung volumes, functional residual capacity, dead space, and lung heterogeneity in pediatric acute lung injury and ARDS are discussed, alongside the physiologic impact of ventilator settings including tidal volume, respiratory rate, PEEP, FiO₂, and mean airway pressure.
Participants are also guided through commonly used oxygenation and ventilation indices – including PF ratio, oxygenation index, saturation-based indices, alveolar–arterial gradients, and dead space measurements – with a critical discussion of their strengths, limitations, and appropriate clinical interpretation.
The session concludes by examining the physiologic rationale behind permissive hypercapnia, prone positioning, and PEEP titration, emphasizing individualized, patient-specific decision-making rather than protocol-driven ventilation alone.
This webinar serves as a core educational resource for clinicians involved in pediatric respiratory and critical care, and sets the stage for upcoming PRCCS sessions focused on ventilation–perfusion mismatch, shunt physiology, and advanced bedside assessment of gas exchange.
