Clinical Respiratory Physiology by Luke Harris (Auth.)

By Luke Harris (Auth.)

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No plateau (non-uniform emptying and uneven VjQJ) - Alveolar plateau (uniform emptying ± uneven F/QJ Expiration Alveolar-arterial 0 2 Difference (A — aD0 2 ) The alveolar air equation will be mentioned in Chapter i o. However, for calculation of alveolar-arterial O 2 differ­ ence (A — aD02) the full equation may be used: PAO2 = Fio2 (PB - 47) - °2 R Paco 2 X F i o 2 (i - R)\ _ R PaC (but if R = i the term in square brackets becomes o; if VENTILATION-PERFUSION RATIOS 31 R = ο·8 it only becomes 2 mm Hg!

Combining (a) and (b) for Pco 2 can be direct because of linearity of C 0 2 dissociation curve 8 0 + 4 (30) Ί-hLJ. = 4 o m m H g . 5 d. For oxygen (because of S-shaped dissociation curve) (a) + (b) must be combined in terms of 0 2 content first: *5 + 4 v(l9'6) 0 1 / i -^ ^ v ' = 18-7 ml /ioo ml 5 which gives saturation of 18-7 X 100 = 93'5 P e r cent 20 which would give P o 2 of 75 mm Hg (these 0 2 values would be low for a man of 40 years of age). Thus 20 per cent underventilation can be com­ pensated by overventilation as far as Paco 2 is concerned but some hypoxaemia persists.

Dye Dilution Method Cardiac output can be measured by dilution of an injectable substance—indocyanine green, coumassie blue, 1 3 1 I labelled human albumin, or cold saline. Indocyanine green has the advantage of being measurable by spectrophotometry, usable on exercise, repeatability, does not require steady state for measurements and is independent of arterial oxygen content. Coumassie blue can be detected with an ear oximeter; 131l requires a scintillation counter. Cold saline method measures temperature changes with a thermistor.

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