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diagnosis management criticalcare pulmonary differential respiratory interpretation syndrome acidbase comparison abg acidosis algorithm ards criteria pathophysiology alkalosis bloodgas hypoxia oxygen
Markers of Organ Dysfunction in Severe Sepsis Altered consciousness Confusion Psychosis Tachycardia Hypotension Altered CVP Altered
Altered CVP Altered PAOP ... Tachypnoea PaO2 ... <70mmHg SaO2 < ... 90% PaO2/FiO2 300%
Hypoxia and Hypoxemia - Overview Hypoxia - insufficient oxygen delivered to tissues to meet demands Hypoxemia - low
O2 is inspired) PAO2 ... reaches the alveoli) PaO2 ... Low SvO2 → Low PaO2 ... Low SvO2 → Low PaO2 ... sepsis) - High PaO2
Approach to the A-a Gradient A-a gradient = PAO2 - PaO2 A-a gradient = [FiO2 x (Patm -
A-a gradient = PAO2 ... - PaO2 A-a gradient ... (Patm - 47) - (PaCO2 ... /0.8)] - PaO2 Simplified ... /0.8)] - PaO2 Normal
Hepatopulmonary Syndrome HPS - Diagnosis: 1. Patients with liver disease 2. Alveolar-arterial oxygen gradient (AaP02) >15 mmHg
Moderate HPS: ≥ 60 PaO2 ... Severe HPS: ≥ 50 PaO2 ... Very severe HPS: PaO2
Hypoxemia vs Hypoxia Hypoxemia - Partial pressure of arterial oxygen (PaO2) is below normal Hypoxia - Insufficient oxygen
arterial oxygen (PaO2 ... compensate for low PaO2
Oxygen Delivery Equation DO2 = CO x {(1.39 x Hb x sO2) + (PaO2 x 0.03)} DO2 =
x Hb x sO2) + (PaO2 ... effective hemoglobin PaO2 ... in your hands = PaO₂
Berlin Criteria for Acute Respiratory Distress Syndrome (ARDS) - Respiratory symptoms must have begun within one
inspired oxygen (PaO2 ... - 200 mm Hg < PaO2 ... - 100 mm Hg < PaO2 ... H2O - Severe - PaO2
PROSEVA definition of ARDS Thus, the PROSEVA trial essentially modifies the Berlin definition of ARDS, with the
requirement that the PaO2 ... requires that the PaO2
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 Causes of Falsely Low Oxygen Saturation - Discordant SpO2 & PaO2 • Motion • Low
Discordant SpO2 & PaO2 ... Discordant #SpO2 #PaO2
Understanding & Treating ARDS - Acute Respiratory Distress Syndrome • Timing - within one week of
Impaired Oxygenation PaO2
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