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Approach to the A-a Gradient A-a gradient = PAO2 - PaO2 A-a gradient = [FiO2 x (Patm -
Intracardiac, Pulmonary ... V/Q Mismatch: Pulmonary ... , Atelectasis, Pulmonary ... Diffusion Defect: Pulmonary ... alveolar #arterial #pulmonary
Acid-Base Disorders - Differential Diagnosis Algorithm Acidemia (pH < 7.35) • Metabolic Acidosis (HCO3 < 24mmol/L) CO2
HCO3 < 24mmol/L) CO2 ... Respiratory Acidosis (pCO2 ... HCO3 > 28mmol/L) CO2 ... Respiratory Alkalosis (pCO2 ... Diagnosis #Algorithm #Causes
Capnography Measurement of exhaled carbon dioxide can be used to confirm ETT placement, for safer procedural sedation,
monitor cardiac & pulmonary ... • PvCO2 - Mixed ... venous CO2 • ... PaCO2 - Arterial ... patterns #diagnosis #pulmonary
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
→ ↓ → →↑ Pulmonary ... +2PDP)/3 Mean Pulmonary ... MPAP-WP)*79.92)/CO Pulmonary ... MPAP-WP)*79.92)/CI Pulmonary ... = 1.36 cmH20 PULMONARY
Hypoxia and Hypoxemia - Overview Hypoxia - insufficient oxygen delivered to tissues to meet demands Hypoxemia - low
type of hypoxia) PIO2 ... O2 is inspired) PAO2 ... Low SvO2 → Low PaO2 ... Hypoxemia #summary #pulmonary ... differential #diagnosis #causes
Basics of Waveform Capnography Waveform capnography assesses ventilation by monitoring exhaled carbon dioxide Can use measurement and morphology
data regarding pulmonary ... pathophysiology CLINICAL ... WAVEFORM - Critical ... output state - Pulmonary ... patterns #diagnosis #pulmonary
ABG vs VBG: Arterial vs Venous Blood Gases ABG PROS: Tells you exactly what the arterial environment looks
vs Venous Blood Gases ... looks like (pH, PaCO2 ... Comparison #pH #pCO2
Oxygen-Hemoglobin Dissociation Curve Left Shift (↓ O2 unloading to tissue), Left = Lower: • ↓ H+ (↑
+ (↑ pH) • ↓ PCO2 ... + (Acid) • ↑ PCO2 ... pathophysiology #pulmonary
Hypoxemic Respiratory Failure - Differential Diagnosis Framework DECREASED INSPIRED OXYGEN • Low PATM Can decrease first part
HYPOVENTILATION • Rising PaCO2 ... lung diseases, pulmonary ... asthma, COPD, pulmonary ... shunting (eg, pulmonary ... Differential #Diagnosis #pulmonary
Acid Base Disorders - Blood Gas Interpretation Steps for Blood Gas Interpretation: 1. Acidemia or Alkalemia? 2.
7.35-7.45 • PaCO2 ... 35-45 mmHg • PaO2 ... Metabolic: pH pCO2 ... Acetazolamide Causes ... Classically” noted with pulmonary
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