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RRT ABGs
Question | Answer |
---|---|
A-a Gradient: | The difference(gradient)between alveolar and arterial PO2 |
A-a Gradient Formula: | A-aDO2=PAO2-PaO2 *PAO2 must be calculated first |
PAO2: Alveolar Air Equation: | PAO2=(PB-Ph2O)FIO2-PaCO2 *PaCO2 is divided by .8* PB=747 pH20=47 |
Shortcut for Alveolar Air Equation when using it for A-a Gradient | PAO2=(7xFIO2 as whole number)-(PaCO2+10) |
Normal A-a Gradient: | 25-65% on 100% |
V/Q Mismatch(too much deadspace): | 66-300 Common when PE is involved |
Shunting: | >300 |
What is Arterial Oxygen Content? | Best measurement of oxygen delivered to the tissues, or the best index of oxygen transport. Measures Lung Function. |
"Oxygen in RBC": | 1.34 |
"Oxygen in Plasma": | .003 |
Arterial Oxygen Content Formula: | CaO2=(Hbx1.34xSaO2)+(PaO2x.003) |
What is Mixed Venous Oxygen Content? | Total amt of oxygen carried in the mixed venous blood. Measures Heart Function. |
Mixed Venous Content Formula: | CvO2=(Hbx1.34xSvO2)+(PvO2x.003) |
Normal CvO2: | 14%(12-16%) |
Normal CaO2: | 17-20% |
C(a-v)O2: | CvO2 is subtracted from CaO2. Measures the oxygen consumption of the tissues. |
C(a-v)O2 Norm: | 4-5 vol % |
PaO2/FIO2 or P/F Ratio: | Used in determination of Acute Lung Injury(ALI). |
P/F Ratio Norm: | 380 mmHg or greater |
A P/F Ratio of less than 200 mmHg indicates what? | ARDS |
A P/F Ratio of less than 300 indicates what? | Acute Lung Injury |
Qs/Qt(Shunt)Equation: | Qs/Qt=(A-aDO2).003/(A-aDO2).003 +C(a-v)O2 |
Qt(Cardiac Output)Equation: | VO2/C(a-v)O2(10) *ALL numbers are given except 10* |
VO2(Oxygen Consumption)Equation: | VO2=QtxC(a-v)O2x10 |
How is PaO2 estimated from the SaO2? | Subtract 30 from SaO2 |
Vd/Vt(deadspace to tidal vol)Ratio Formula: | PaCO2-PECO2x100/PaCO2 |
Vd/Vt Norm: | 20-40%(Up to 60% for vent pts) |
Most common cause for an increased Vd/Vt ratio: | Pulmonary Embolism |
Desired Minute Volume Formula: | (VExPaCO2)=(VExPaCO2) |
Desired PaO2 Formula: | FIO2xDesired PaO2/Current PaO2 |
What do you do for an abnormal PCO2 with normal pH? | Don't change anything. Indicative of a chronic pt with COPD. |
When the pH is inside the acceptable range(7.35-7.45): | It is Compensated or Chronic |
When the pH is outside the acceptable range(7.35-7.45): | It is Non-Compensated or Acute |
Respiratory Vs. Metabolic: Respiratory | A Respiratory Acidosis or Alkalosis is the diagnosis when the pH is abnormal b/c of a change in PCO2. |
Respiratory Vs. Metabolic: Metabolic | A Metabolic Acidosis or Alkalosis is the diagnosis when the pH is abnormal b/c of a change in HCO3-. |
ABG Normal for Newborn: | pH:>7.30 PaCO2:<50 PaO2:>50 |
COPD Pt in Acute Resp. Failure(Loss of Hypoxic drive): | pH:7.30 PaCO2:80 PaO2:80 HCO3-:38 |