O2 and metabolic demand Flashcards
Receptors that utilize norepi and epi
Adrenergic receptors
Adrenergic receptors
Alpha, Beta 1 and Beta 2
Alpha-adrenergic receptors cause
Vasoconstriction
Beta 2
Bronchodilation
Beta 1
Heart rate
Conduction
Contractions
Stress is controlled by which system
Autonomic nervous system
Autonomic nervous system 2 sub divisions
Parasympathetic nervous system
Sympathetic nervous sytem
Parasympathetic nervous system
Rest and digest
Sympathetic nervous system
Fight or flight
Interventions to reduce demand
Intubation Sedatives paralysis Bed rest Mechanical ventilation
How do we assess oxygen supply and demand
End organ perfusions
Lactate
SvO2 and ScvO2
Oxygen extraction (O2ER)
Oxygen Demand
The amount of O2 cells needs to provide energy (ATP) for their function
Increased cellular work means
Increased cellular oxygen demand
The need for increased fuel for cells to functions
Assessing end-organ perfusion HEART
Angina pain
shortness fo breath
ECG changes
Increased cardiac bio markers
Assessing end-organ perfusion LUNGS
Poor gas exchange
Decreased muscle function
Assessing end-organ perfusion GI
Decreased gastric motility abd pain nausea vomiting Ischemia to the bowel
Assessing end-organ perfusion BRAIN
Decreased LOC
REstlessness
Agitation
Coma
Assessing end-organ perfusion LIVER
Changes in Labs
Assessing end-organ perfusion KIDNEYS
ddecreased output
BUN CR and GFR
Assessing end-organ perfusion Skin/ Tissue perfusion
skin warmth colour pulse strength cap refill
Assessing GLOBAL end-organ perfusion
Increased lactate Poor perfusion ScVO2 EOP ABG O2ER
Lactate
Produced when cells switch from aerobic to anaerobic metabolism- lactate is generated as a by-product
Tells us that tissues don’t have enough oxygen
<2 is normal
ScvO2
central venous oxygen saturation
Percentage of oxygen bound to hemoglobin in venous blood returning to heart from top of body (drawn from superior vena cava) -usually drawn from IJ
Tells us about our demand- what is left over
Where is ScvO2 drawn from
drawn from the distal port in CVC (IJ)