Blood Gases

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Author:
tsbatiste
ID:
264943
Filename:
Blood Gases
Updated:
2014-03-31 10:03:02
Tags:
VTHT Anesthesia Surgery
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Description:
various gases in the blood
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  1. This abbreviation means arterial plasma
    Pa
  2. This abbreviation mean venous plasma
    Pv
  3. This abbreviation is the concentration of oxygen in arterial plasma
    PaO2
  4. This abbreviation is the concentration of carbon dioxide in arterial plasma
    PaCO2
  5. The 4 methods to accurately assess respiratory function:
    • 1. Blood pressure monitor
    • 2. Blood gas analysis
    • 3. Pulse Oximetery
    • 4. Capnography
  6. What is the reason to assess respiratory function?
    To determine whether the patient is obtaining oxygen and delivering it to tissues and how efficiently the lungs are eliminating CO2
  7. How can ventilation volume be estimated
    • 1. visual observation of the chest
    • 2. rebreathing bag movement
    • 3. ventilometry
  8. This device is attached to the anesthetic machine to measure expired tidal volume.
    Ventilometer
  9. Normal tidal volume range
    5-10mL/lb
  10. Normal minute volume range
    150 - 250mL/kg/min
  11. Normal range for PaCO2
    35 - 45 mmHg
  12. This value of PaCO2 indicates hyperventilation/respiratory alkalosis and decreased cerebral blood flow
    less than 35mmHg
  13. This value of PaCO2 indicates excessive respiratory acidosis and hypoxemia that warrants PPV support.
    greater than 60mmHg
  14. How can values of PvCO2 be estimated?
    Adding 3 to 6 mmHg to the PaCO2 value
  15. How much total oxygen does oxygenated blood contain in a 100mL sample?
    20mL O2 (19.7mL SaO2, 0.3mL PaO2)
  16. What does PvO2 reflect?
    Tissue PO2 and has no bearing on PaO2
  17. PvO2 value range
    40 - 50 mmHg
  18. This value of PvO2 can be caused by anything that decreases the delivery of O2 to the tissues
    less than 30mmHg
  19. While breathing room air, a PvO2 value of what suggests reduced tissue uptake of O2?
    greater than 60mmHg
  20. Normal PaO2 value range
    90-115 mmHg
  21. These values of PaO2 and SaO2 represent normal conditions
    PaO2 > 80mmHg, SaO2 > 95%
  22. These values of PaO2 and SaO2 represent hypoxemia
    PaO2 <60 mmHg, SaO2 <90%
  23. These values of PaO2 and SaO2 represent very serious hypoxemia
    PaO2 <40 mmHg, SaO2 <75%
  24. 3 ways CO2 is transported in the blood
    • 1. Joined to hemoglobin
    • 2. Dissolved in plasma
    • 3. Reacts with water to form carbonic acid then converted to bicarbonate and hydrogen ions
  25. What percentage of CO2 is joined to hemoglobin?
    30%
  26. What percentage of CO2 is dissolved in plasma?
    10%
  27. What percentage of CO2 reacts with water to form carbonic acid, then converted to bicarbonate and hydrogen ions?
    60%
  28. Carbonic acid chemical formula
    H2CO3
  29. What are the general criteria for an area to place a pulse oximeter probe?
    • 1. Hairless
    • 2. Unpigmented
    • 3. Thin skin
  30. What is the most common SaO2 probe location?
    Tongue
  31. Oxygen delivery to tissues depends on:
    • 1. Lungs (O2 from environment to plasma)
    • 2. Adequate hemoglobin present
    • 3. Sufficient cardiac output
    • 4. Arterial blood pressure sufficient to maintain cerebral and coronary perfusion
    • 5. Vasomotor tone not too excessive
  32. Which measurements can adequate oxygen delivery be extrapolated from?
    • 1. Capillary Refill Time
    • 2. Pulse Quality - palpation
    • 3. Urine Output
    • 4. Temperature changes
    • 5. PvO2
  33. Normal urine output
    1 to 2 mL/kg/hr
  34. Three ways abnormal electrical activity is manifested:
    • 1. Bradycardia
    • 2. Tachycardia
    • 3. Arrhythmias
  35. True or False, and normal ECG indicates normal myocardial performance and tissue perfusion
    False
  36. Vasomotor tone is assessed by:
    • 1. Capillary Refill Time
    • 2. Mucous Membrane Color
    • 3. Urine Output
    • 4. Toe web/core temp gradient
  37. This is the measurement of luminal pressure of the intra-thoracic vena cava as it enters the right auricle
    Central Venous Pressure
  38. Two things that CVP gives:
    • 1. how well blood returns to the heart
    • 2. ability of the heart to receive/pump blood
  39. When is a CVP value useful?
    • 1. right side failure (Caval syndrome)
    • 2. prevention of over hydration in animals on iv (puppy/kittens)
  40. Which arteries are commonly used for invasive blood pressure monitoring of an equine patient?
    carpal and tibial artery
  41. Normal ETCO2 concentrations
    35-45 mmHg (add 4-10mmHg to approximate PaCO2)

    • Canine: 35-40mmHg
    • Feline: 32-35mmHg

    (Dr. Y 18-40 mmHg in surgery)
  42. Describe a normal capnograph
    • 1.Baseline upon inspiration should be 0
    • 2. Wave should appear like a rounded rectangle
    • 3. ETCO2 should be around 40mmHg
  43. Describe a hypoventilation capnograph
    • 1. Baseline upon inspiration should be 0
    • 2. Wave still appears like a rounded rectangle
    • 3. ETCO2 above 40mmHg
  44. List things that could give a hypoventilation capnograh
    • 1. Opioids
    • 2. Inhalant gas anesthetics
    • 3. Propofol
  45. Describe a hyperventilation capnograph
    • 1. Baseline upon inspiration should be 0
    • 2. Waves are rounder
    • 3. Peak are lower than 18mmHg and more frequent
  46. List reasons for a hyperventilation capnograph
    • 1. Anesthesia too light
    • 2. Endotracheal cuff not inflated properly
    • 3. Oxygen flow insufficient
    • 4. Kink in endotracheal tube
  47. Describe a Spontaneous Breathing capnograph while under a mechanical ventilation
    1. Intermittent normal waves followed by shorter waves
  48. What is the reason for a spontaneous breathing capnograph while under mechanical ventilation indicative of?
    Apneustic respirations
  49. Advantages of mainstream capnography
    • 1 rapid reading
    • 2 no dilution necessary
  50. Disadvantages of mainstream capnography
    • 1. sensor could extubate the patient due to weight
    • 2. expensive
    • 3. adds dead space
  51. Describe a rebreathing capnograph
    • 1. Baseline no longer 0
    • 2. General shape: rounded rectangle beginning with sloped ending
    • 3. Peak above 40 mmHg
  52. List reasons for a rebreathing capnograph
    • 1. Pop off valve closed
    • 2. Saturated CO2 absorbant
    • 3. Expiratory valve malfunction
  53. Describe an obstructive capnograph
    • 1. Baseline on inspiration should be 0
    • 2. A sloped plateau of wave but usually within normal ETCO2 range
  54. List reasons for a obstructive capnograph
    • 1. asthma
    • 2. blocked endotracheal tube
    • 3. collapsed trachea
  55. Advantages of sidestream capnography
    • 1. light weight
    • 2. MRI compatible
    • 3. less expensive
  56. Disadvantages of sidestream capnography
    • 1. delayed recording (2-3 breaths behind)
    • 2. sample tube clogging occurs
    • 3. replacement tube costs
  57. This value of ETCO2 represents hypercapnia/hypercarbia
    Greater than 45mmHg
  58. This value of ETCO2 represents hypocapnia/hypocarbia
    less than 30mmHg
  59. What happens if the ETCO2 gets too high (>60mmHG)?
    Animal will hyperventilate
  60. Cause of an artificially high ETCO2
    crack in mainstream adaptor
  61. Common causes of an ETCO2 that is too low:
    • 1. leak in endotracheal tube
    • 2. crack in sidestream sampler
    • 3. condensation in sidestream sampler
    • 4. Improper calibration
    • 5. low cardiac output from patient
  62. What is the minimal acceptable conscious blood press mean according to Dr. Sawyer?
    60mmHg
  63. McKelvey blood pressure value for a conscious animal
    • systolic = 120 mmHg
    • diastolic = 80 mmHg
    • mean = 94 mmHg
  64. What is the correction factor for a doppler reading done on a feline?
    Add 14 mmHg

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