Get an ABG. Then use the A-a gradient equation: PAO2 - PaO2 = ([Patm - PH2O] x FiO2 - [PaCO2/Q]) - PaO2 = ([Patm - 47] x FiO2 - [PaCO2/0.8]) - PaO2 = (150 - [PaCO2/0.8]) - PaO2, when at sea level with a patient breathing room air.
+
Get an ABG. Then use the alveolar gas equation:
−
A-a gradient increases with age, use equation: (Age+10)/4.
+
*PAO2 - PaO2
+
*PAO2 = ([Patm - PH2O] x FiO2 - [PaCO2/Q])
+
*PAO2 = ([Patm - 47] x FiO2 - [PaCO2/0.8])
+
*PAO2 = (150 - [PaCO2/0.8]) (when at sea level with a patient breathing room air)
+
+
Normal A-a gradient increases with age, use the equation: (Age+10)/4.
=Differential=
=Differential=
Line 17:
Line 22:
** Hypoventilation (increased PaCO2)
** Hypoventilation (increased PaCO2)
** Low SvO2 (low cardiac output, high O2 consumption)
** Low SvO2 (low cardiac output, high O2 consumption)
+
+
=Special Situations=
+
*CCBs can be a 'gas-fire on atelectasis' due to pulmonary vasodilation and disruption of V/Q matching leading to worsened shunt and hypoxemia