Baker's technique: Difference between revisions

Revision as of 23:09, 3 March 2013

The alveolar air equation is the method for calculating partial pressure of alveolar gas (P_AO₂). The equation is used in assessing if the lungs are properly transferring oxygen into the blood. The alveolar air equation is not widely used in clinical medicine, probably because of the complicated appearance of its classic forms.

Interpretation

To clinically interpret P_aO₂ one has to also know the patient's P_aCO₂, F_IO2 (fraction of inspired oxygen) and the P_B (barometric pressure), all components of the equation for P_AO₂.

Equations

Several possible equations exist to calculate the alveolar air.^[1]^[2]^[3]^[4]^[5]^[6]^[7]

P_{A} O_{2} = F_{I} O_{2} (P B - P H_{2} 0) - P_{A} C O_{2} (F_{I} O_{2} + \frac{1 - F I O 2}{R})

P_{A} O_{2} = P_{I} O_{2} - P_{A} C O_{2} (F_{I} O_{2} + \frac{1 - F_{I} O_{2}}{R})

P_{A} O_{2} = P_{I} O_{2} - \frac{V_{T}}{V_{T} - V_{D}} (P_{I} O_{2} - P_{E} O_{2})

P_{A} O_{2} = \frac{P_{E} O_{2} - P_{I} O_{2} (\frac{V_{D}}{V_{T}})}{1 - \frac{V_{D}}{V_{T}}}

Abbreviated alveolar air equation

P_{A} O_{2} = \frac{P_{E} O_{2} - P_{i} O_{2} \frac{V_{D}}{V_{T}}}{1 - \frac{V_{D}}{V_{T}}}

P_AO₂, P_EO₂, and P_iO₂ are the partial pressures of oxygen in alveolar, expired, and inspired gas, respectively, and VD/VT is the ratio of physiologic dead space over tidal volume.^[8]

Respiratory quotient (R)

R = \frac{P_{E} C O_{2} (1 - F_{I} O_{2})}{P_{i} O_{2} - P_{E} O_{2} - (P_{E} C O_{2} * F_{i} O_{2})}

Physiologic dead space over tidal volume (VD/VT)

\frac{V_{D}}{V_{T}} = \frac{P_{A} C O_{2} - P_{E} C O_{2}}{P_{A} C O_{2}}

Template:Mechanical ventilation

References

↑ Raymond L, Dolan W, Dutton R, et al: Pulmonary function and gas exchange during altitude hypoxia (abstract). Clin Res 19:147, 1971
↑ Spaur WH, Raymond LW, Knott MM, et al: Dyspnea in divers at 49.5 ATA: Mechanical not chemical in origin. Undersea Biomed Res 4:183-198, 1977
↑ Rossier P-H, Blickenstorfer E: Espace mort et hyperventilation. Helv Med Acta 13:328-332, 1946
↑ Riley RL, Lilienthal JL Jr, Proemmel DD, et al: On the determination of the physiologically effective pressures of oxygen and carbon dioxide in alveolar air. Am J Physiol 147:191-198, 1946
↑ McNicol MW, Campbell EJM: Severity of respiratory failure: arterial blood gases in untreated patients. Lancet 1:336-338, 1965
↑ Begin R, Renzetti AD Jr: Alveolar-arterial oxygen pressure gradient: I. Comparison between an assumed and actual respiratory quotient in stable chronic pulmonary disease; Relationship to aging and closing volume in normal subjects. Respir Care 22:491-500, 1977
↑ Suwa K, Geffin B, Pontoppidan H, et al: A nomogram for deadspace requirement during prolonged artificial ventilation. Anesthesiology 29:1206-1210, 1968
↑ Fenn WO, Rahn H, Otis AB: A theoretical study of the composition of alveolar air at altitude. Am J Physiol 146:637-653, 1946

[1] Raymond L, Dolan W, Dutton R, et al: Pulmonary function and gas exchange during altitude hypoxia (abstract). Clin Res 19:147, 1971

[2] Spaur WH, Raymond LW, Knott MM, et al: Dyspnea in divers at 49.5 ATA: Mechanical not chemical in origin. Undersea Biomed Res 4:183-198, 1977

[3] Rossier P-H, Blickenstorfer E: Espace mort et hyperventilation. Helv Med Acta 13:328-332, 1946

[4] Riley RL, Lilienthal JL Jr, Proemmel DD, et al: On the determination of the physiologically effective pressures of oxygen and carbon dioxide in alveolar air. Am J Physiol 147:191-198, 1946

[5] McNicol MW, Campbell EJM: Severity of respiratory failure: arterial blood gases in untreated patients. Lancet 1:336-338, 1965

[6] Begin R, Renzetti AD Jr: Alveolar-arterial oxygen pressure gradient: I. Comparison between an assumed and actual respiratory quotient in stable chronic pulmonary disease; Relationship to aging and closing volume in normal subjects. Respir Care 22:491-500, 1977

[7] Suwa K, Geffin B, Pontoppidan H, et al: A nomogram for deadspace requirement during prolonged artificial ventilation. Anesthesiology 29:1206-1210, 1968

[8] Fenn WO, Rahn H, Otis AB: A theoretical study of the composition of alveolar air at altitude. Am J Physiol 146:637-653, 1946

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+The '''alveolar air equation''' is the method for calculating partial pressure of alveolar gas (P<sub>A</sub>O<sub>2</sub>). The equation is used in assessing if the lungs are properly transferring oxygen into the blood.  The alveolar air equation is not widely used in clinical medicine, probably because of the complicated appearance of its classic forms.
+== Interpretation ==
+To clinically interpret P<sub>a</sub>O<sub>2</sub> one has to also know the patient's P<sub>a</sub>CO<sub>2</sub>, F<sub>IO2</sub> ([[fraction of inspired oxygen]]) and the P<sub>B</sub> ([[barometric pressure]]), all components of the equation for P<sub>A</sub>O<sub>2</sub>.
+==Equations==
+Several possible equations exist to calculate the alveolar air.<ref>Raymond L, Dolan W, Dutton R, et al: Pulmonary function and gas exchange during altitude hypoxia (abstract).
+Clin Res 19:147, 1971</ref><ref>Spaur WH, Raymond LW, Knott MM, et al: Dyspnea in divers at 49.5 ATA: Mechanical not chemical in origin. [[Undersea Biomed Res]] 4:183-198, 1977</ref><ref>Rossier P-H, Blickenstorfer E: Espace mort et hyperventilation. [[Helv Med Acta]] 13:328-332, 1946</ref><ref>Riley RL, Lilienthal JL Jr, Proemmel DD, et al: On the
+determination of the physiologically effective pressures of oxygen and carbon dioxide in alveolar air. [[Am J Physiol]] 147:191-198, 1946</ref><ref>McNicol MW, Campbell EJM: Severity of respiratory failure: arterial blood gases in untreated patients. [[The Lancet|Lancet]] 1:336-338, 1965</ref><ref>Begin R, Renzetti AD Jr: Alveolar-arterial oxygen pressure gradient: I. Comparison between an assumed and actual respiratory quotient in stable chronic pulmonary disease; Relationship to aging and closing volume in normal subjects. [[Respir Care]] 22:491-500, 1977</ref><ref>Suwa K, Geffin B, Pontoppidan H, et al: A nomogram for
+deadspace requirement during prolonged artificial ventilation.
+[[Anesthesiology]] 29:1206-1210, 1968</ref>
+:<math> P_A O_2 =  F_I O_2(PB-P H_2 0) - P_A CO_2 (F_I O_2 + \frac{1-FIO2}{R})</math>
+----
+:<math> P_A O_2 = P_I O_2 - P_A CO_2 (F_I O_2 + \frac{1-F_I O_2}{R})</math>
+----
+:<math> P_A O_2 = P_I O_2 - \frac{V_T}{V_T-V_D}(P_I O_2 - P_E O_2)</math>
+----
+:<math> P_A O_2 = \frac{P_E O_2 - P_I O_2 (\frac{V_D}{V_T})}{1- \frac{V_D}{V_T}}</math>
+=== Abbreviated alveolar air equation ===
+::<math>P_A O_2 = \frac{P_E O_2 - P_i O_2 \frac{V_D}{V_T}}{1- \frac{V_D}{V_T}}</math>
+P<sub>A</sub>O<sub>2</sub>, P<sub>E</sub>O<sub>2</sub>, and P<sub>i</sub>O<sub>2</sub> are the partial pressures of oxygen in alveolar, expired, and inspired gas, respectively, and VD/VT is the ratio of physiologic dead space over tidal volume.<ref>Fenn WO, Rahn H, Otis AB: A theoretical study of the composition of alveolar air at altitude. [[Am J Physiol]] 146:637-653, 1946</ref>
+=== Respiratory quotient (R) ===
+:<math>R = \frac{P_E CO_2 (1-F_I O_2)}{P_i O_2 - P_E O_2 - (P_E CO_2 * F_i O_2)}</math>
+=== Physiologic dead space over tidal volume (VD/VT) ===
+:<math>\frac{V_D}{V_T} = \frac{P_A CO_2 - P_E CO_2}{P_A CO_2}</math>
+{{Mechanical ventilation}}
+==References==
+<references/>
+[[Category:Respiratory therapy]]
+[[Category:Pulmonology]]
+[[Category:Mechanical ventilation]]
+[[Category:Mathematics in medicine]]

Baker's technique: Difference between revisions

Revision as of 23:09, 3 March 2013

Contents

Interpretation

Equations

Abbreviated alveolar air equation

Respiratory quotient (R)

Physiologic dead space over tidal volume (VD/VT)

References

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Baker's technique: Difference between revisions

Revision as of 23:09, 3 March 2013

Interpretation

Equations

Abbreviated alveolar air equation

Respiratory quotient (R)

Physiologic dead space over tidal volume (VD/VT)

References

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