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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 ... Classically” noted with pulmonary ... Diagnosis #Summary #Nephrology
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
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
Basics of Waveform Capnography Waveform capnography assesses ventilation by monitoring exhaled carbon dioxide Can use measurement and morphology
data regarding pulmonary ... Assessing for CO2 ... Transition as CO2 ... output state - Pulmonary ... patterns #diagnosis #pulmonary
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
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