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Hall Lecture > Respiration And Respiratory Monitoring > Flashcards

Respiration And Respiratory Monitoring Flashcards

0
Q

Euthermic 70 kg pt, metabolic jumping off point

A

242 ml/min

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1
Q

Metabolic jumping off point equation

A

Vo2= W^0.75 * 10 (ml/min)

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2
Q

Respiratory quotient

A

R=Vco2/Vo2

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3
Q

Resp quotient for metabolically euthermic patient

A

0.8

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4
Q

CO2 production equation

A

Vco2=Vo2*R

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5
Q

Vco2 for metabolically normal 70kg pt

A

Vco2=242 ml/min * 0.8

= 194 ml/min

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6
Q

Co2 produced where in cell?

A

Mitochondria

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7
Q

Minute ventilation

A

Total vol of gases moving into and out of the lungs each minute

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8
Q

Minute ventilation for pt w equal tidal volumes (equation)

A

Ve=Vt*f

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9
Q

Pt w breaths of diff vol, min vent equation

A

Ve=summation of Vt in one minute

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10
Q

Co2 leaves gas exchange region by

A

Diffusion

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11
Q

Co2 transported thru conducting airway by

A

Convection to the mouth and nose

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12
Q

Pressure H2O

A

47 mmHg at 37C

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13
Q

Pbar at sea level

A

760 mmHg

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14
Q

Pbar atl

A

737 mmHg

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15
Q

Boyles law

A

P1V1=P2V2

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16
Q

Dalton’s law

A

P1+P2+…+Pn=Ptotal

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17
Q

Fractional concentration

A

Fx=Px/Ptotal or f1+f2+…fn=1.00

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18
Q

Alveolar ventilation (Va)

A

Total vol of gases flowing into and out of gas exchange region each minute

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19
Q

Partial pressure of co2 in alveoli

A

Paco2=40mmhg (ideal alveolar value for a normal eucapnic pt)

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20
Q

Normal range for paco2

A

36-44 mmHg

21
Q

Water vapor pressure

A

47 mmHg

22
Q

Total pressure of gases in alveoli under dry conditions

A

Pbar=737-47mmhg=690mmhg

23
Q

Calculate alveolar ventilation

A

Paco2Va=pbarvaco2 ==> paco2/Pbar=vaco2/va

24
Q

Alveolar ventilation (to get co2 out of parynchema) for 70kg euthermic pt

A

3346ml/min

25
Q

Faco2=paco2/Pbar for euthermic 70kg pt

A

0.06

26
Q

Va=vaco2/faco2

A

Va=194ml/min / 0.06 =3346 ml/min

27
Q

Volume of conducting airways

A

Anatomic dead space

28
Q

VdANAT

A

Anatomical dead space calculated based on weight

29
Q

VdAnat constant

A

2.2ml/kg =1ml/lb

30
Q

Anatomic dead space ventilation (V w dot on top) is product of

A

Anatomic dead space times respiratory rate

31
Q

For 70kg pt breathing 10 times per min , dead spaces ventilation would be

A

Vdanat=(vdanat2.1ml/kg)10

32
Q

Anatomic dead space ventilation

A

Less than amount needed to get rid of co2 in airway as compared to parynchema

33
Q

Minute ventilation

A

Total vol of gases moving into and out of lung each Minute

34
Q

Minute ventilation equation

A

Ve=va+vdanat

35
Q

Minute ventilation for 70kg pt breathing 10x/min

A

Ve=va+vdanat=3346 +1540 ml/min =4886 ml/’min

36
Q

How to calculate tidal volume

A

Vt=ve/f = 4886ml/min /10 ml =488.6 ml (set your tidal vol to this

37
Q

What’s coming out when we breathe?

A

Upper, lower, alveolar gasses

38
Q

Plateau in waveform in capnography

A

Alveolar has leaving parenchyma

39
Q

The only true measure of effectiveness of ventilation

A

Arterial partial pressure of co2 (paco2)

40
Q

O2 is carried in whole blood in what 2 forms

A

Dissolved o2 and o2 bound to hemoglobin (in equilibrium w one another)

41
Q

Where does the gas exchange region begin?

A

17th generation

42
Q

Where does the gas exchange region end?

A

23rd generation

43
Q

Lung compliance is the

A

Ability for the lungs to expand

44
Q

Compliance equation

A

Change in volume divided by change in pressure

45
Q

Lung thoracic compliance equation

A

Clt=tidal volume / airway pressure . (Vt/Paw) in ml/cmh2o

46
Q

Total Compliance for normal awake pt

A

100 ml/cmh2o

47
Q

Smaller the lung thorax compliance number =

A

Less compliance meaning lungs r more stiff and rigid

48
Q

Lung and thorax in a series

A

1/Clt=1/Cl + 1/Ct where these are individual compliance a

49
Q

Normal lung compliance

A

200ml/cmh2o

50
Q

Normal thoracic compliance

A

200ml/cmh2o

51
Q

An obese patient more than likely will have a

A

Small thoracic compliance ie 50ml/cmh2o and can have a normal lung compliance (patients will vary)

Hall Lecture (2 decks)

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