Carbon Dioxide Analysis Flashcards

1
Q

What are components of carbon dioxide?

A

A polyatomic structure and can be measured using infrared absorption analysis

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2
Q

What are two less common methods for measuring carbon dioxide analysis?

A

Fluorescence quenching and the Severinghaus CO2 electrode

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3
Q

When is a Colorimetric Carbon Dioxide Sensor used?

A

A special situation for measuring carbon dioxide is when away from the anesthesia machine (i.e. ICU or code of floor)

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4
Q

What is Colorimetric Carbon Dioxide Sensor used to determine?

A

Assure correct placement of endotracheal tube (ETT).

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5
Q

What is analyzed in Colorimetric Carbon Dioxide Sensor?

A

Exhaled CO2

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6
Q

What is the principle of Colorimetric Carbon Dioxide Sensor?

A

utilizes a change in color of a chemically treated paper

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7
Q

What happens to the Colorimetric Carbon Dioxide Sensor when exposed to C02?

A

An instant reaction will change the color of the paper indicating the presence of CO2.

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8
Q

What is true about newer Colorimetric Carbon Dioxide Sensor?

A

Some newer colorimetric sensors will even give estimate of the amount of CO2 detected.

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9
Q

The appearance of a purple color on the Colorimetric Carbon Dioxide Sensor indicates a CO2 of ____ mmHG and _______ % CO2.

A

<4 mmHg and <0.5%

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10
Q

The appearance of a tan color on the Colorimetric Carbon Dioxide Sensor indicates a CO2 of ____ mmHG and _______ % CO2.

A

4-15 mmHg and 0.5-2% CO2

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11
Q

The appearance of a Gold color on the Colorimetric Carbon Dioxide Sensor indicates a CO2 of ____ mmHG and _______ % CO2.

A

CO2 >15 mmHg and >2%

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12
Q

What is the difference about CO2 Fluorescence Quenching?

A

CO2 does not have the ability to do florescence quenching.

Instead, CO2 will change the pH, liberating hydrogen ions, which react with a quenching agent in the sensor.

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13
Q

CO2 will change the _____, liberating hydrogen ions, which react with a quenching agent in the sensor.

A

pH

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14
Q

What causes the change in florescence in terms of CO2 Fluorescence Quenching?

A

Changed florescence is caused by CO2 and this change can be measured

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15
Q

CO2 Fluorescence Quenching- the change is directly proportional to the concentration of _______ present

A

CO2

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16
Q

What is the severinghaus electrode?

A

modified glass electrode;

  • The electrode contains some sodium bicarbonate, which reacts with the CO2;
  • The reaction changes the pH in the electrode, which corresponds to a change in potential difference, and this is measured.
  • The CO2is then inferred from the change in pH
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17
Q

Severinghaus PCO2 Electrode: The CO2dissolved in the sample diffuses into the middle compartment of the electrode via a _______________.

A

thin (silicon polymer) membrane

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18
Q

Severinghaus PCO2 Electrode: Once inside, the CO2finds itself in a _____________

A

bicarbonate solution

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19
Q

Severinghaus PCO2 Electrode: The reaction which takes place is an old familiar _________________.

A

Carbonic acid dissociation equilibrium:

CO2 + H2O ⇌ H2CO3 ⇌ H+ + HCO3-

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20
Q

Severinghaus PCO2 Electrode: What cause the generate a current of electrical charge?

A

Hydrogen ions are liberated

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21
Q

Severinghaus PCO2 Electrode: The ________ of the solution in the middle chamber changes.

A

pH

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22
Q

Severinghaus PCO2 Electrode: The change in pH is completely dependent on the pCO2, provided the ______ and _______ remain constant.

A

temperature and pressure

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23
Q

Severinghaus PCO2 Electrode: So from the change in pH, the _____ can be calculated.

A

PCO2

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24
Q

Severinghaus PCO2 Electrode: This current is _________ to the carbon dioxide concentration present.

A

proportional

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25
How does oxygen enter human circulation?
Enters the lungs and then is passed on into blood.
26
What is the main way that oxygen is carried to our body?
Hemoglobin
27
What is deoxy Hb?
The hemoglobin without oxygen is de oxygenated hemoglobin
28
What is oxy Hb?
The hemoglobin with oxygen, we will call oxygenated hemoglobin
29
What is oxygen saturation?
the percentage of the available hemoglobin that carries oxygen
30
What does pulse oximetry use to determine O2?
Light
31
What is the basic foundation of pulse oximetry?
Light is emitted from light sources which goes across the pulse oximeter probe and reaches the light detector.
32
How does placing a finger in between a light source help to determine pulse oximetery?
Part of the light will be absorbed by the finger and the part not absorbed reaches the light detector.
33
What two principles help to determine the amount of light passing through a finger in pulse oximetery?
principals of the physics laws by Lambert and Beer.
34
What is Lambert's Law?
The intensity of transmitted light decreases as the distance traveled through the substance increases.
35
What is Beer's Law?
The intensity of transmitted light decreases as the concentration of the substance increases
36
What two components are important in determining how much light is absorbed in pulse oximetry?
The concentration of the solution and the distance the light must travel
37
What will hemoglobin absorb?
Light
38
What is the relationship of light and Hb in blood?
The amount of light absorbed is proportional to the concentration of Hb in the blood vessel.
39
How can the pulse oximetery determine how much light has been absorbed?
By measuring how much light reaches the light detector
40
More Hb in the finger= ________ absorbed
more light
41
Less Hb in the finger= ________ absorbed
Less
42
What law analyzes the relationship of light and Hb in blood?
Beer's Law
43
What does light have to travel through, according to Lambert's Law?
Artery
44
Lambert’s Law: Amount of light absorbed is ______ to the length of the path that the light has to travel.
Proportional
45
When type of artery will light have a shorter path of travel?
Narrow artery
46
When type of artery will light have a longer path of travel?
Wider artery
47
According to lambert's law, will the concentration of Hb be different based on the size of the artery?
Though the concentration of Hb is the same in both arteries, the light meets more Hb in the wider artery, since it travels in a longer path.
48
Longer path the light must travel =_______ absorbed.
More light
49
Shorter path the light must travel =_______ absorbed.
Less light
50
How does pulse oximetry measure SpO2?
Comparing oxyhemoglobins and deoxyhemoglobins differential absorption of light.
51
What two types of lights used in pulse oximetry?
Red and Infrared Light
52
What is the wavelength of red light?
660 nm
53
What is the wavelength of Infrared light?
940 nm
54
What is important about the wavelengths of red and infrared light?
the absorption of oxyhemoglobin and deoxyhemoglobin differs greatly
55
What light spectrum will oxyhemoglobin absorbs more light?
Infrared spectrum (940 nm)
56
What light spectrum will deoxyhemoglobin absorbs more light?
Red spectrum (660 nm)
57
What does the pulse oximeter module calculate?
Oxyhemoglobin/deoxyhemoglobin ratio- compares this ratio to an empirical algorithm (which varies by company) and displays a corresponding value on the digital read out.
58
What determines the empirical algorithm in pulse oximetry?
Established by testing healthy volunteers when given a hypoxic mixture
59
What is the range for the established empirical algorithm in pulse oximetry?
70-100%
60
SPO2 reading of 100% describe the absorbance of Oxy Hb
Infrared light absorbed>Red light
61
SPO2 reading of 0% describe the absorbance of Deoxy Hb
Absorption of Red light> Infrared Light
62
SPO2 reading 75% describe absorbance pattern
The absorbance pattern is now somewhere in between the oxy Hb curve and deoxy Hb curve. The ratio of absorbed red light and infrared light is different and using this information, the pulse oximeter is able to calculate the oxygen saturation as 75 %.
63
What is present in the blood at a wavelength of SPO2 reading 75%?
The blood has both, oxy Hb and deoxy Hb | Red light absorption> Infrared light
64
What is absent in blood when the SP02 is 100%?
Deoxygenated hemoglobin
65
What is absent in blood when the SP02 is 0%?
Oxygenated hemoglobin
66
SPO2 is 50% describe the absorbance pattern
The absorbance pattern is different, the ratio of red light and infrared light absorbed is also therefore different and the pulse oximeter uses this to calculate the saturation Red light > Infrared Light
67
What can the pulse ox distinguish?
Pulsatile flow
68
What is the process that pulse ox uses to measure pulsatile flow?
Plethysmography
69
What is plethysmography?
which measure volume it is possible to distinguish which ratio corresponds with the highest volume reading
70
What is the highest volume reading in plethysmography?
Arterial wave
71
What corresponding readings does the pulse oximeter make?
Ratio and volume every second
72
Plethysmography, will filter out ____________
The readings and only keeps the reading corresponding to the highest volume
73
What is arterial blood gas (ABG)?
Measures dissolved gases in, and other properties (pH, etc.) of arterial blood gas
74
What is the comparison of ABGs to Pulse oximeter?
Pulse oximeter is less invasive and more often used; however, it does not predict the percentage as precisely nor does it offer information on other properties of the arterial blood.
75
What is the body sensitive to?
pH level
76
What occurs to the body if pH is not in acceptable range?
Proteins are denatured and digested, enzymes lose their ability to function.
77
What three components tightly regulate the body's pH?
Respiratory system, Renal system and buffering agents
78
What impact does the respiratory system have in effecting ABGs?
Changes in the amount of dissolved CO2 in the blood affects the amount of carbonic acid and therefore the pH.q
79
Increased CO2 ventilation ____________ pH
Increase Blood PH (alkalotic)
80
Decreased CO2 ventilation __________ pH
Decrease Blood pH (acidotic)
81
What is respiratory compensation?
A process that occurs rapidly to restore homeostasis
82
What impact does the renal system have in effecting ABGs?
Changes the retention and secretion of bicarbonate and hydrogen ions.
83
If the renal tubular cells retain more bicarb and secret more H+, then blood pH will _________
Increase (alkalotic).
84
If the renal tubular cell secrete bicarb and retain H+, then blood pH will __________
Decrease (acidotic)
85
What is metabolic compensation?
A much slower process than respiratory compensation.
86
Define pH.
Acidity or alkalinity of the blood | 7.35-7.45
87
Define PaCO2.
Used to assess the respiratory component of acid/base regulation 35-45 mmHg
88
Define PaO2.
The patient's oxygenation status | 75-100 mmHg
89
Define HCO3.
Used to assess the metabolic component of acid/base regulation 22-26 mEq/L
90
Define O2 Saturation
Saturation of hemoglobin | 95-100%
91
Define Base excess
An isolated view of the metabolic component. | + or - 2 mmol/ L
92
Review ABG interpretations and how to determine if compensation is occurring or not
Last slides 60-65 slides of power point
93
ABG interpretations: Opposite directions indicate a ________
Primarily respiratory disorder
94
ABG interpretations: Same directions indicate a ________
Primarily metabolic disorder