Common challenges and trouble-shooting in ICU Flashcards
What is hypoxia?
Low oxygen supply to bodily tissues
Hypoxaemia ?
Low oxygen content of blood
What is the definition of hypoxaemia ?
PO2 < 8kPa (Normal 10-13kPa)
What is oxygen?
Electron acceptor in mitochondrial matrix
What does electron transport drive?
ATP production or synthesis
What is the value of pressures at atmospheric air?
760mmHg
What is the equivalent of 760mmHg in kPa?
This is equivalent to 100kPa
Conversion of mmHg to kPa?
Diving the value of mmHg by 7.5
The first stage of reduction of PO2?
Humidification
Subtraction of water vapor pressure 47mmHg
=0.21 x (760mmHg - 47mmHg) = 149mmHg or 20kPa
Alveolar air is determined by?
- Alveolar ventilation
- Pulmonary blood flow
What is the alveolar gas equation?
PaO2 = PiO2 - pCO2 / R
R = 0.8
pCO2 = usual CO2 concentration 40mmHg
= 149 - 40 /0.8 = 99mmHg or 13kPa
Oxygen cascade?
See image attached
Hypoventilation will decrease the following values?
Oxygen - Decrease
Carbondioxide - Increase
What are the main causes of hypoxia?
- Alveolar hypoventilation
- Limited diffusion capacity
- Shunts - Admixture of venous blood (Bronchial & thebesian veins)
- V/Q mismatch (Most important)
What types of shunts do you know?
- Intra-cardiac
- Intra-pulmonary
What is an intracardiac shunt?
Blood passes through an abnormal channel in the heart without passing through the lungs
What is intrapulmonary shunt?
The blood does not take part in gas exchange
What is the only cause of refractory hypoxia?
Shunt
What are the causes of intrapulmonary shunts?
- Cardiogenic pulmonary oedema
- ARDS
- Pneumonia
- Pulmonary haemorrhage
- Atelectasis