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Normal pH
7.35-7.45
<7.35 Acid
>7.45 alkalosis
respiratory aklalosis
pH> 7.45, PaC02 low, HC03 low
respiratory acidosis
pH < 7.35
PaCO2 > 45
Hc03 normal 22-26
Metabolic alkalosis
pH > 7.45
HCO3 > 26
PaC02 45-35
normal oxygen levle
80-100
mild hypoxemia
60-80
moderate hypoxemia
40-60
severe hypoxemia
<40
A-a gradiatian calculation is a calculation of what?
level of hypoxia
PA02-Pa02
, A-a gradiant varies with age, calculation
2.5 + 0.21 x age in years
5 causes of hypoxemia
VQ mismatch
shunt
PNA, interstitial lung dz
hypoventilation
high altitude
clinical symptoms that require intubation
neuromuscular depression or failure.
spinal cord injuries
guillain barre syndrome
trauma-spinal cord injuries, phrenic nerve injury
myasthenia gravis
shock
status asthmaticus
sustained apnea of any kind
indications for weaning from vent
underlying process that required the vent is corrected
maintaining oxygen status
no presser support- levophed, epinephrine, etc.
Pa02 >80, FI02 of 0.5, and PEEP <8.0 cm H20
prior to seperation from the vent proceed with this ...... to determine if pt is able to
dc vent
trial of spontaneous breathing
Volume targeted assist control (AC) mode
the clinician determines tidal volume and rate/ pt can still breath over the vent. example:
pt gets RR of 12 but has an additional 2 breaths on their own, pt will still breathe 14
breaths/min. tidal volume is based on the vent.
Synchronized intermittent mandatory ventilation SIMV