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Concepts Related to Oxygenation

Concepts Related to Oxygenation. James Barnett, RN, MSN Vanderbilt University Medical Center May 2007. Measurements. PaO 2 (partial pressure of arterial 0 2 ) SaO 2 (arterial oxygen saturation) SpO 2 (pulse oximeter saturation) SvO 2 (mixed venous blood saturation). PaO 2.

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Concepts Related to Oxygenation

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  1. Concepts Related to Oxygenation James Barnett, RN, MSN Vanderbilt University Medical Center May 2007

  2. Measurements • PaO2 (partial pressure of arterial 02) • SaO2 (arterial oxygen saturation) • SpO2 (pulse oximeter saturation) • SvO2 (mixed venous blood saturation)

  3. PaO2 • Partial pressure of oxygen dissolved in arterial blood • Dependent on • Altitude • Age • Normal (sea level) = 80 – 100 mmHg

  4. PaO2 • Abnormally low PaO2 = hypoxemia • Causes • Inability to ventilate appropriately (paralysis, rib fractures, secretions) • Low cardiac output states (CHF, MI, Shock) • Alveolar diffusion failure (pneumonia, ARDS) • Low environmental oxygen states (high-altitude)

  5. SaO2 • Measures percentage of arterial hemoglobin sites saturated with oxygen • Direct measure from an arterial sample • Normal > 93% • Remember: hemoglobin carries oxygen to the tissues

  6. SpO2 • Measures percentage of arterial hemoglobin sites saturated with oxygen • Indirect measure from pulse oximeter technology • Normal range is > 93%

  7. SvO2 • Percent of hemoglobin sites saturated with oxygen after tissue oxygenation has occurred • Indicates adequacy of tissue oxygenation • Methods • Pulmonary artery catheter access • Venous access

  8. SvO2 • Normal = 60 – 80% • Formula: (dual oximetry) • SaO2 – SvO2 = % of O2 removed from the hgb by the tissues • Usually 20 – 40%

  9. Decreased oxygen delivery (DaO2) Low hematocrit Hypoxemia Low cardiac output Shock (SvO2 < 40% can  profound shock) Increased tissue demand for oxygen Hyperthermia Pain Stress Shivering Seizures Low SvO2

  10. Increased oxygen supply High FiO2 Technical problems with reading Wedged Swan - Ganz Decreased oxygen demand Hypothermia Anesthesia Hypothyroidism High SvO2

  11. Finished • You have completed this in-service. Please complete the post-test titled: • Concepts Related to Oxygenation

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