Oxygen Theory
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| Aerobic metabolism | sustain life, metabolism that occurs in the presence of oxygen, can produce a lot of energy (ATP)
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| Anaerobic | able to grow and function without air or oxygen - in the cytoplasm
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| oxygen | colorless, tastleless, transparent gas
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| What does oxygen exist in atmosphere | 21%
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| Four classifications of Tissue Hypoxia | 1. Hypoxemia (hypoxic hypoxia) 2. Hemoglobin defiency (anemic hypoxia) 3. low blood flow (circulatory hypoxia) 4. dysoxia (histotoxic hypoxia)
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| Hypoxemia (Hypoxic hypoxia) | inadequate delivery of oxygen to the lun or from the lung to the blood RESPONDS TO O2
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| Causes of hypoxemia | hypoventilation, breathing at high altitude, shunt (atelectasis), V/Q mismatch, diffusion defects
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| Hemoglobin Defiency (anemic hypoxia) | anemia refers to low amounts of hemoglobin (Hb) in the blood. RESPONDS TO O2
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| causes of hemoglobin defiency (anemic hypoxia) | loss of Hb, decreased Hb production, abnormal Hb, or an impaired chemical combination of Hb (carbon monoxide poisoning)
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| Low blood flow (circulatory hypoxia) | sufficient blood flow is not reaching the tissue and therefore oxygen is not being delivered. O2 THERAPY LIMITED
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| causes of low blood flow (circulatory hypoxia) | cardiac pump failure, CHF, shock, ischemia
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| Dysoxia (histotoxic hypoxia) | poisoning of the cellular oxygen utilization mechanism has occured (the cell is not able to accept oxygen from the blood to utilize it. DOES NOT RESPOND TO O2
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| Causes of dysoxia (histotoxic hypoxia) | cyanide poisoning
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| Acute hypoxia sign/symptoms | tachypnea, increase RR, tachycardia, hypertension, increase CO, Arrythymia, restlessness, liver and kidney damage
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| Chronic Hypoxia signs/symptoms | persistent mental and physical fatigue, secondary polycythemia, restlessness, clubbing, increase size of heart (right side failure) (cor pulmonale)
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| Indication for O2 use | Documented hypoxemia PaO2 thes than 60 mmHg or SaO2 less than 90%
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| Oxygen toxicity | result of increased FiO2
2 factors: effective dose and duration
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| Signs/symptoms of oxygen toxicity | tachypnea, fatigue, anxiety, irritation of trachea, mild cough, pain in inspiration, N/V, decreased vital capacity
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| Hypoventilation | increased PaO2
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| Retinopathy of Prematurity (ROP) | increased PaO2, irreversible damage to the retina of an infant due to exposure to high levels in the arterial blood. Greater than 80 mmHg.
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| Bronchopulmonary Dysplasia (BDP) | fibrotic tissue damage caused by the exposure of high levels of inhaled oxygen (FiO2)to the immature lung tissue in a premature baby for a long period of time
FiO2 is greater than 40% for more than 24-72 hours
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| absorption atelectasis | collapse of alveoli as the result of high levels (FiO2) in the inhaled air causing elimination of N2 from the lung.
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| Shift to RIGHT on curve | Decrease affinity
Decrease pH
Increase in Temp
increase 2,3,DPG
increase in PCO2
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| Shift to LEFT on curve | increase affinity (O2 transferred to the blood and HgB)
increase in pH
decrease in temp
decrease 2,3 DPG
Decrease in PCO2
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| Hypoxia | lack of oxygen at the tissue level
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| Hypoxemia | lack of oxygen in the arterial blood (decreased PaO2)
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| Hyperoxia | increased levels of O2 to tissues usually due to the use of supplemental O2
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| Secondary polycythemia | increased production of RBCs. More RBCS available to carry oxygen to the tissues
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| cyanosis | visible bluish tinge of the skin and mucous membranes
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| CaO2 | content in the amount of oxygn in a substance expressed as volume %.
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| CaO2 calculation | CaO2 = (Hb x 1.34 x SaO2) + (PaO2 x .003)
Hemoglobin plasma
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| normal CaO2 | 20.4 vol%
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| Alveolar Air Equation | PAO2 = [Pb - 47)FiO2]- PACO2/8
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| Normal A-a gradient | 5-10 mmHg on room air no more than 65 mmHg on 100% oxygen
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| A-a gradient calculation | P(A-a)O2 = PAO2- PaO2
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