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Monitoring > Oxygenation Monitoring > Flashcards

Oxygenation Monitoring Flashcards

1
Q

Arterial Content

A

17-20 mlO2/dL

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2
Q

Venous content

A

12-15 mL O2/dL

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3
Q

A-v content difference

A

4-6 mLO2/dL

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4
Q

Normal Oxygenation Delivery

A

950-1150mL O2/min

Index 550-650 mLO2/min/m^2

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5
Q

Normal Oxygenation consumption

A

200-250 mLO2/min

120-160 mLO2/min/m^2

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6
Q

Normal Oxygen reserve

A

700-800 mLO2/min

450 mLO2/min/m^2

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7
Q

Shivering

A

50-100% increase in consumption

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8
Q

Sepsis

A

50-100% increase in consumption

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9
Q

Ischemic hypoxia

A

Low blood flow caused by:

Obstruction of Vessels

Coronary/cerebral thrombosis or spasms

Peripheral vascular disease

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10
Q

Hypoxemic hypoxia

A

Inadequate transfer of oxygen from lungs to hemoglobin

Causes:

Hypoxemia pO2 <60mmHg

Carbon monoxide poisoning

Methemoglobin (Fe 2+ to Fe 3+)

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11
Q

Anemic hypoxia

A

Lack of hemoglobin

Hemorrhage

Nutritional deficiencies

Hematopoietic problems

Dilution

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12
Q

Toxic hypoxia

A

Inability of cells to uptake oxygen

Causes:

Sepsis

Cyanide toxicity

Ethanol toxicity

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13
Q

Excessive tissue requirements

A

Oxygen demand higher than the system can supply

Causes:

Hypermetabolism 
Systemic inflammatory response syndrome
Sepsis
Delirium Tremens(alcohol withdrawals)
Status seizures 
Thyroid storm
Extreme fevers
Malignant hyperthermia
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14
Q

Impaired Oxygen unloading

A

Capillary level causes:

Alkalemia
Hypocarbia
Large dose of prbc

Bohr shift left

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15
Q

Increase oxygen demand

A
  • patient conditions
  • medication

Sympathetic agonist

-procedure

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16
Q

Decrease oxygen consumption

A 
-hypothermia 
7 degree rule 50% decrease
-morphine
-anesthesia 
-assist/control ventilation
-neuromuscular blocking agents
17
Q

Compensation mechanism for impaired tissue Oxygenation

A
  1. Increase co
  2. Take from venous reserve 75-32%
  3. Polycythemia (long)
18
Q

Monitoring oxygen transport

A
  1. Arterial and mixed venous sample via lab
  2. Point of care blood has
  3. Non invasive pulse oximetry
  4. Invasive mixed venous saturation
  5. Continuous indwelling arterial blood gas
  6. Transcutaneous measurement of local tissue saturation
19
Q

Spo2 ranges

A

96-99% normal
85-90% mild tissue hypoxia
75-85% significant tissue hypoxia

20
Q

Morbid neurological outcomes type 1

A
  • Cerebral death
  • non fatal stroke
  • new tia

Greater than 70 4-9% chance

Aortic artherosclerosis
History of neurological events 15%
Carotid stenosis
# of gme

21
Q

Morbid neurological outcomes type 2

A

New intellectual deterioration

New seizures post op

Predictors:

Low co or hypotension 
Gme
Atrial arrhythmias
Systolic hypertension 
Diabetes
Pulmonary disease 
Alcoholism
22
Q

Affecting blood Oxygenation

A 
-Delivery
Increase map
Increase co2
-increase flow via ci
Increase hematocrit
-adjust head position
  • consumption
  • increase anesthetics
  • decrease temperature
23
Q

EEG

A

Superficial electrical monitoring of brain

Voltage difference between electrodes

Synaptic activity of post synaptic potentials

10-20 electrodes

Alpha-relaxed and awake
Beta-alert and awake
Theta-child infant sleeping
Delta- coma deep sleep, deep anesthesia, cerebral ischemia(BAD)

Used for epilepsy!
Need tech to read!

24
Q

Bispectral index

A

Processed eeg info to a number and graph

Every 10-15 sec

How?

Reads and calculates

  1. EEG
  2. High frequency power spectrum 14-30
  3. Low frequency bispectrum 1-2
  4. Suppression of eeg near and total

Number and graph given

1-100 scale. 100 awake

40-60 good anesthesia

Benefit 
Less anesthetic 
Decrease awareness
Good recovery time
Patient satisfaction

Disadvantage

Trending only
Can only treat when on bypass
Monitor screen

25
Q

NIRS

Cerebral oximetry

In is

A

Non invasive continuous monitoring of cerebral o2.

Not pulse dependent

New objective data, not just trend

Mortality decrease 3%

Attach above eyebrows
And set baseline!

Use deep and shallow 8ch infrared

Interventional threshold
20% decrease from baseline or below 50

Critical threshold
25% drop from baseline or less than 40

Monitoring (1 decks)

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