14 results
Hypoxemia Differential Diagnosis Algorithm by A-a Gradient

Normal A-a Gradient:
 • ↓ Atmospheric pressure
 • Hypoventilation: CNS
Right-to-Left Shunt ... (↑Shunting), ↓Perfusion ... Dead space) • ↓Diffusion ... Diagnosis #Algorithm #pulmonary ... #Aa #Gradient
Approach to the A-a Gradient
A-a gradient = PAO2 - PaO2
A-a gradient = [FiO2 x (Patm -
(assumes Room Air ... Right to Left Shunt ... - Anatomic Shunt ... - Physiologic Shunt ... Disease and more • Diffusion
Hypoxemic Respiratory Failure - Differential Diagnosis Framework
DECREASED INSPIRED OXYGEN
 • Low PATM Can decrease first part
VIQ mismatch and shunt ... lung diseases, pulmonary ... gravity-dependent gradients ... asthma, COPD, pulmonary ... embolus SHUNT
Hepatopulmonary Syndrome - Diagnosis and Management Summary
A defect in arterial oxygenation due to a gas exchange
1) or anatomic shunt ... Arterial blood gas (ABC ... cirrhosis • Intra-pulmonary ... scanning or pulmonary ... 80mmHg or A-a gradient
CPAP Troubleshooting Tips
1. Wrong size/style mask → try a different mask, nasal pillows
2. Trouble getting used
try a different mask ... tolerating forced air ... noise → check air ... Troubleshooting #Tips #management ... #problems #pulmonary
Oxygen Delivery by Device

Nasal Cannula 
• Indicated for low-flow, low-percentage supplemental oxygen. 
• Flow rate of
Nonrebreather Mask ... entrainment of room air ... Venturi Mask (venti-mask ... Delivery #FiO2 #Pulmonary ... Equipment #Devices #Management
Mask Oxygen Delivery Devices

Simple Mask aka Hudson's Mask:
 • Flow 6-10 LPM
 • FiO2 35-50%
Face Tent:
Mask Oxygen Delivery ... aka Hudson's Mask ... oxygen ambient air ... Delivery #Devices #management ... #pulmonary #criticalcare
Perform computations online at:
ScyMed.com
6th ED
ICU-card
«ICU, Formulas & Drugs»
HEMODYNAMIC PATTERNS
Condition
SAP
CVP

PAP PCWP

CO C(a-v)02 PVR

SVR
Hypovolemic shock
↓
↓
↓
↓
↓
↑
↑
↑
Cardiogenic shock
↓
1
↑
1

1
↑

Septic shock
↓
↓
↓
↓
↑
↓
↓
↓
Cardiac Tamponade
.
↑
↑
1
↓

→
↑
RV
DP-PCWP Coronary Perfusion ... Qt 0.0-7.0 % Shunt ... )*(100) | A-a GRADIENT ... -25 mmHg A-a Gradient ... 0.25*age) A-a Gradient
#ICUCard
RENAL
GFR
90-131
mL/min
((140-age)*Wt)/(72*Cr)
Glomerular Filtration Rate (Cockcroft)
CI Cr
90-131
mL/min
(CrU * volume)/CrS
Creatinine Clearance
FENa
0.0-1.0
%
((U/P Na)/(U/P Cr))*100
Fractional Excretion of Na+
Na req
mEq
(125-Na)*0.6*Wt
Required Sodium
FE Urea
Tubular Potassium Gradient ... 70 mmHg on 100% mask ... A-a Gradient > ... MV < 10L/min, Shunt ... /500mL NS) IV Infusion
Preoperative Risk Evaluation

Major Pre-Op Questions:
1. Does the patient have any modifiable risk factors that could be
specific questions to ask ... murmur 3/6) - Pulmonary ... indication of AC ... days before Pulmonary ... medical and surgical management