This second session of the series explores the complex mechanisms of hypoxemia through a practical, bedside-focused approach to ventilation–perfusion (V/Q) mismatch and shunt physiology. Designed for a multidisciplinary critical care audience, the webinar bridges core respiratory physiology with real-world clinical decision-making in the PICU.
Participants will learn how to recognize common clinical patterns of hypoxemia and determine whether ventilation, perfusion, or diffusion is the dominant problem. Using routinely available monitoring tools – including SpO₂ trends, FiO₂ requirements, end-tidal CO₂, and arterial blood gases – the session will demonstrate how to detect gas-exchange failure early and assess severity using key indices such as the SF ratio, PF ratio, A–a gradient, and Oxygenation Index.
The webinar will also focus on translating physiology into action, guiding clinicians in the selection of appropriate respiratory interventions such as oxygen delivery strategies, PEEP and recruitment maneuvers, positioning and proning, and secretion management. Attention will be given to optimizing patient–ventilator interaction through adjustments in support level, inspiratory time, respiratory rate, and alarm settings to reduce desaturation events.
Finally, the session emphasizes effective team-based communication and escalation strategies for refractory hypoxemia, including when to consider advanced therapies such as inhaled nitric oxide, HFOV, and referral for ECMO.
This webinar is particularly relevant for critical care nurses, respiratory therapists, physiotherapists, fellows, and practicing consultants seeking a structured, physiology-driven approach to managing hypoxemia in critically ill children.
