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Hypoxia and Hypoxemia - Overview
Hypoxia - insufficient oxygen delivered to tissues to meet demands
Hypoxemia - low
O2 is inspired) PAO2 ... Low SvO2 → Low PaO2 ... Low SvO2 → Low PaO2 ... sepsis) - High PaO2 ... summary #pulmonary #differential
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 ... /0.8)] - PaO2 Simplified ... /0.8)] - PaO2 Normal ... Hypoxia #hypoxemia #differential
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 ... Syndrome #diagnosis #management
Hypoxemia vs Hypoxia
Hypoxemia - Partial pressure of arterial oxygen (PaO2) is below normal
Hypoxia - Insufficient oxygen
arterial oxygen (PaO2 ... compensate for low PaO2 ... hypoxia #hypoxemia #differential
Acid Base Disorders Worksheet

Step 1: Gather the necessary data (Na+, CI-, HCO3-, PH, pCO2). Preferably, all
CI-, HCO3-, PH, pCO2 ... 3: Look at the pCO2 ... . 3a: If pCO2 ... diagnoses using the differentials ... Worksheet #diagnosis #differential
Acid-Base Disorders - Differential Diagnosis Algorithm
Acidemia (pH < 7.35)
 • Metabolic Acidosis (HCO3 < 24mmol/L) CO2
Acid-Base Disorders - Differential ... Respiratory Acidosis (pCO2 ... Respiratory Alkalosis (pCO2 ... AcidBase #Disorders #Differential
Berlin Criteria for Acute Respiratory Distress Syndrome (ARDS) 
- Respiratory symptoms must have begun within one
week of a known clinical ... inspired oxygen (PaO2 ... - 200 mm Hg < PaO2 ... - 100 mm Hg < PaO2 ... H2O - Severe - PaO2
Acid Base Disorders - Blood Gas Interpretation

Steps for Blood Gas Interpretation: 
1. Acidemia or Alkalemia? 
2.
Differentials? ... 7.35-7.45 • PaCO2 ... 35-45 mmHg • PaO2 ... acidosis Step 5 - Differential ... Base #Gas #VBG #differential
Non-Invasive Ventilation (BiPAP) Algorithm - Indications and Contraindications
Indications for NIV:
 • COPD - pH <7.35, pCO2
COPD - pH <7.35, pCO2 ... VC < 1 even if pCO2 ... or pH <7.35 and pCO2 ... RR or daytime pCO2 ... #criticalcare #management
Platypnea-Orthodeoxia Syndrome on Physical Exam
The case of a patient with a diagnosis of cirrhosis and platypnea-orthodeoxia
there is a drop in SaO2 ... to 90% (and in paO2 ... #PhysicalExam #clinical