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Case Study: Automobile Collision Victim A 37-year-old woman is on a volume-cycled mechanical ventilator on a day when the barometric pressure is 745 mm Hg. The patient is receiving an Fl o 2 of 0.50. The following clinical data are obtained: Hb: 11g/dL ( Pa o 2 ) 60 mm Hg ( Sa o 2 = 90% ) P V ¯ o 2 35 mm Hg ( S V ¯ o 2 = 65% ) Pa c o 2 38 mm Hg Cardiac output: 6 L/min Based on this information, calculate the patient's A. Total oxygen delivery B. Arterial-venous oxygen content difference C. Intrapulmonary shunting D. Oxygen consumption E. Oxygen extraction ratio

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Cardiopulmonary Anatomy & Physiolo...

7th Edition
Des Jardins + 1 other
Publisher: Cengage Learning,
ISBN: 9781337794909
BuyFind

Cardiopulmonary Anatomy & Physiolo...

7th Edition
Des Jardins + 1 other
Publisher: Cengage Learning,
ISBN: 9781337794909

Solutions

Chapter
Section
Chapter 6, Problem 11RQ
Textbook Problem

Case Study: Automobile Collision Victim

A 37-year-old woman is on a volume-cycled mechanical ventilator on a day when the barometric pressure is 745 mm Hg. The patient is receiving an Fl o 2 of 0.50. The following clinical data are obtained:

Hb:    11g/dL

( Pa o 2 )   60 mm Hg  ( Sa o 2  = 90% )

P V ¯ o 2   35 mm Hg  ( S V ¯ o 2  = 65% )

Pa c o 2   38 mm Hg

Cardiac output: 6 L/min

Based on this information, calculate the patient's

A. Total oxygen delivery

B. Arterial-venous oxygen content difference

C. Intrapulmonary shunting

D. Oxygen consumption

E. Oxygen extraction ratio

Expert Solution
Summary Introduction

Case summary: A 37-year-old woman met with an accident and is on a volume-cycled mechanical ventilator.

Characters in the case: A 37-year-old woman met with an accident.

Adequate information: The barometric pressure is 745 mm Hg. She was receiving FlO2 of 0.50.

To determine: The total oxygen delivery, the arterial venous content difference, the intrapulmonary shunting, oxygen consumption, and the oxygen extraction ratio.

Explanation of Solution

Given information:

Cardiac output: 6 L/min

Hb: 11g/dL

PaO2: 60 mm Hg

Pv¯O2: 35 mm Hg

PaCO2: 38 mm Hg

With this information,

PAO2=(BP-PH2O) FlO2-PaCO2(1.25)=(745-47) 0.5 - 38(1.25)=(698)0.5 - 47.5=349 - 47.5=301.5

CcO2=(Hb×1.34)+(PAO2×0.003)=(11×1.34)+(301.5×0.003)=14.74+0.90=15.64

CaO2=(Hb×1.34×SaO2)+(PaO2×0.003)=(11×1.34×0.90)+(60×0.003)=13.266+0.18=13.44

Cv¯O2=(Hb×1.34×Sv¯O2)+(Pv¯O2×0.003)=(11×1.34×0.65)+(35×0.003)=9.581+0.105=9.686

A)

Totaloxygen delivery=QT×CaO2×10=6×13446×10=806

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