Blood Gases Pathophysiology And Interpretation

Mark P. Hamlin Peter J. Pronovost

Ventilation

Mmuteventilation

Dead Space

Dead Space

Alveolar Ventilation

GasPressyres Diffusion,, ofGases

Gas,, Diffusion, , ThroUngh, , the, ,Respirat,orY,,Memh,r,a,n,e

Al.veolaLGas.es inspiredGases

Humidificationof, inspiredAiT

Rate„at,Which„Alveolar,Air, Is „Renewed,, „by,, Atmospheric ,,Air OxygenConcentration, ,,a,n,d,,,,P,artj,al,,P,re,S,S,ure,, ,i,n,,the„ Alveoli Carbon, „Dioxide „Concentration,, ,in,,the, Alveoli Alveolar Gas Equation End-JidalGases Arteria.lBloo.d,, Gases

Partial „Pressure„o.f„Arteiia„l, „Carbon, „Dioxide Partial Pressure of Arterial Oxyqen

Alveolar-Arterial „Oxyqen „Differences OxyMmoqloMtSMuratiofl Other,nMethods„of EvaluatiM oxxqenation PhysioloqicShuntinq, „inthe „Lunq, (Venous-ArtMaLAdMxture)

OxyqenAvailability

Oth.e.rMe.thods,,, of„Eya.lua.tinq„Blood„, Gases Pu.lmonary,,Artery,,Ca.th.ete.rs

Noninvasive „Monitorinq

CljniGal,,,Ap.proach,to „the, „Ventilator ,,and,,,Respiratory,,Failure Oxyqenation

Treatment Ventilation B.ibiio.qra.ph.y

Human lungs serve two distinct functions: ventilation and oxygenation. Ventilation, which determines the clearance of carbon dioxide from the body, is a function of the rate and depth of breathing. Oxygenation is the diffusion of oxygen from the lungs to the bloodstream for subsequent delivery to the tissues. The separation between oxygenation and ventilation is dramatically demonstrated by the apnea test for determining brain death. During this test, 100% oxygen is insufflated via a thin catheter placed near the carina in an apneic, unventilated patient. The peripheral oxygen saturation is 90 to 100% despite no clearance of carbon dioxide with severe acidosis. This dramatic example clearly distinguishes the two functions.

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