hypercarbia and hypoxemia
DESCRIPTION
Hypercarbia and Hypoxemia. 11.7.11. What happens to our cells if we don’t get enough O 2 ?. What happens to our cells if we don’t get enough O 2 ?. Cannot make ATP. What happens to our cells if we don’t remove CO 2 ?. What happens to our cells if we don’t remove CO 2 ?. - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/1.jpg)
Hypercarbia and Hypoxemia11.7.11
![Page 2: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/2.jpg)
What happens to our cells if we don’t get enough O2?
![Page 3: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/3.jpg)
What happens to our cells if we don’t get enough O2?
Cannot make ATP
![Page 4: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/4.jpg)
What happens to our cells if we don’t remove CO2?
![Page 5: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/5.jpg)
What happens to our cells if we don’t remove CO2?
CO2 is not bad by itself but can combine with H2O in the blood makes carbonic acid change in pH can cause structure changes in proteins if 3D structure can lead to loss in function.
![Page 6: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/6.jpg)
tissue
CIRCULATION
CO2 O2
PIO2 = 150 mmHgPICO2 = 0.3 mmHg (0)
P aO
2 = 9
8 m
mH
gP a
CO
2 = 4
0 m
mH
g
CO2 O2
P vO
2 = 4
0 m
mH
gP v
CO
2 = 4
5 m
mH
g
PAO2 = 100 mmHgPACO2 = 40 mmHg
Subscripts:I = inhaledA = alveolara = arterialv = venous
Why is PIO2 150 mmHg if atmospheric PO2 is 160 mmHg?
![Page 7: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/7.jpg)
tissue
CIRCULATION
CO2 O2
PIO2 = 150 mmHgPICO2 = 0.3 mmHg (0)
P aO
2 = 9
8 m
mH
gP a
CO
2 = 4
0 m
mH
g
CO2 O2
P vO
2 = 4
0 m
mH
gP v
CO
2 = 4
5 m
mH
g
PAO2 = 100 mmHgPACO2 = 40 mmHg
Subscripts:I = inhaledA = alveolara = arterialv = venous
Why is PIO2 150 mmHg if atmospheric PO2 is 160 mmHg?
Saturation with H2O in the lung space decreases the PO2
![Page 8: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/8.jpg)
Causes of Hypoxemia
1.
2.
3.
4.
![Page 9: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/9.jpg)
Causes of Hypoxemia
1. Diffusion Impairment
2. V/Q Abnormalities
3. Shunt
4. Hypoventilation
![Page 10: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/10.jpg)
Diffusion impairment
PAO2
PcapO2
T
A
.VO2 = K x A x (PAO2 – PaO2)/T
![Page 11: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/11.jpg)
Diffusion impairment .VO2 = K x A x (PAO2 – PcapO2)/T
How does the rate of transport change with:
-Increased thickness, ie. with fibrosis?
-Decreased surface area, ie pneumonia?
-Decreased PcapO2, less O2 in the capillary blood?
![Page 12: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/12.jpg)
Diffusion impairment .VO2 = K x A x (PAO2 – PcapO2)/T
How does the rate of transport change with:
-Increased thickness, ie. with fibrosis?
Slow-Decreased surface area, ie pneumonia?
Slow-Decreased PcapO2, less O2 in the capillary blood?
fast, increased diffusion
![Page 13: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/13.jpg)
V/Q Abnormalities
0Upper parts of the lung receive more/less blood supply than the lower parts (gravity).
0Upper parts of the lung also receive more/ less of the tidal volume.
![Page 14: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/14.jpg)
V/Q Abnormalities
0Upper parts of the lung receive more/less blood supply than the lower parts (gravity).
0Upper parts of the lung also receive more/ less of the tidal volume.
![Page 15: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/15.jpg)
V/Q Abnormalities
0The result is that the upper parts of the lung receive relatively more/less ventilation than they do blood flow, while the lower parts of the lung receive relatively more/less ventilation than they do blood flow.
![Page 16: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/16.jpg)
V/Q Abnormalities
0The result is that the upper parts of the lung receive relatively more/less ventilation than they do blood flow, while the lower parts of the lung receive relatively more/less ventilation than they do blood flow.
![Page 17: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/17.jpg)
Shunt
Definition:
Let’s take a short cut! But is it a good short cut?
![Page 18: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/18.jpg)
Shunt
Definition:
When blood passes from the right heart to the left heart without becoming oxygenated?
![Page 19: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/19.jpg)
ShuntWhich causes blood to go from the right to left heart without going through the lungs?
A. Foreign object (ie. Peanut)B. Bronchial circulationC. Pneumonia or abundant pusD. Foramen Ovale
![Page 20: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/20.jpg)
ShuntWhich causes blood to go from the right to left heart without going through the lungs?
A. Foreign object (ie. Peanut)B. Bronchial circulationC. Pneumonia or abundant pusD. Foramen Ovale
![Page 21: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/21.jpg)
ShuntBronchial circulation- only goes through the larger airways and does not reach the alveolar region
Foramen Ovale- system established in utero that may not close when the baby is born
![Page 22: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/22.jpg)
Shunt
What happens with these two?
Foreign object (ie. Peanut)Pneumonia or abundant pus
![Page 23: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/23.jpg)
Shunt
What happens with these two?Foreign object (ie. Peanut)
Pneumonia or abundant pus
Blood goes through the lungs but does not come into contact with the gas exchange region.
![Page 24: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/24.jpg)
Does hypoventilation cause hypoxemia or hypercarbia?
![Page 25: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/25.jpg)
Does hypoventilation cause hypoxemia or hypercarbia?
BOTH!!
![Page 26: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/26.jpg)
Hypoventilation
What things can cause hypoventilations?1.
2.
3.
4.
![Page 27: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/27.jpg)
Hypoventilation
What things can cause hypoventilations?1. Problems with nerves
2. Problems with muscles
3. Drugs that suppress resp. drive (morphine)
4. Problems with central resp. drive (CCHS, Ondine’s)
![Page 28: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/28.jpg)
Hypercarbia
In addition to hypoventilation,
Think ALVEOLAR VENTILATIONThink DEAD SPACE
![Page 29: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/29.jpg)
How to calculate alveolar ventilation?
![Page 30: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/30.jpg)
How to calculate alveolar ventilation?
VA = (VT V‑ D) x f
![Page 31: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/31.jpg)
What happens when you increase dead space?
VA = (VT V‑ D) x f
![Page 32: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/32.jpg)
What happens when you increase dead space?
VA = (VT V‑ D) x f
Incr. dead space decrease alveolar ventilation increase PaCO2 = hypercarbia if above 40 mmHg
![Page 33: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/33.jpg)
Dead Space
Name 3 things that cause changes in dead space.
![Page 34: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/34.jpg)
Equipment
-Snorkel-Gas Mask-Ventilator
![Page 35: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/35.jpg)
Deep Vein Thrombosis
How does DVT cause dead space?
![Page 36: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/36.jpg)
Deep Vein Thrombosis
How does DVT cause dead space?Sedentary blood clot travels to lung embolus creates dead space decreased gas exchange air in and out is unchanged
![Page 37: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/37.jpg)
![Page 38: Hypercarbia and Hypoxemia](https://reader035.vdocuments.us/reader035/viewer/2022062410/56816108550346895dd050bc/html5/thumbnails/38.jpg)
Air can get in but gas exchange surface is destroyed.