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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
Arterial Blood Gas (ABG) Analysis - Metabolic + Respiratory Acidosis + Alkalosis pH ↓ pCO2 ↓ -
Respiratory Acidosis + Alkalosis ... pH ↓ pCO2 ↓ ... ↑ - Metabolic alkalosis ... Respiratory alkalosis ... Compensation #acidosis #alkalosis
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%
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
-PECO2))/PaCO2 ... age-corrected PAO2 ... /R) | Pa02 80- ... ))+(Pa02*0.0031) ... )-(CvO2) Pa02
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
Acid-Base Disorders - Differential Diagnosis Algorithm Acidemia (pH < 7.35) • Metabolic Acidosis (HCO3 < 24mmol/L) CO2
Respiratory Acidosis (pCO2 ... • Metabolic Alkalosis ... • Respiratory Alkalosis ... (pCO2 < 35 mmHg
Blood Gas Analysis and Interpretation STEPS TO ANALYSIS 1. Look at PH. Alkalotic or acidotic?
Alkalotic or acidotic ... - If alkalotic, ... then it is an alkalosis ... - pCO2 (respiratory ... component) - alkalotic
Acid Base and Blood Gas Analysis 1. pH - What’s the primary disturbance? 2. pCO2 - What’s the
2. pCO2 - What’s ... the pCO2? ... production Respiratory alkalosis ... Salicylates Metabolic Alkalosis ... - Contraction alkalosis
Acid Base Disorders Worksheet Step 1: Gather the necessary data (Na+, CI-, HCO3-, PH, pCO2). Preferably, all
CI-, HCO3-, PH, pCO2 ... has a primary alkalosis ... . 3a: If pCO2 ... >40 patient's alkalosis ... is -Y patient's alkalosis
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 ... ↑ ↑ Metabolic alkalosis ... Acidosis ↑ ↓ Resp Alkalosis
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