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Alveolar Gas Exchange
Pulmonary Artery Blood is O2-Poor, CO2-Rich
Two-Cell Thick Air-Blood Barrier
CO2 Diffuses Into Air
O2 Diffuses Into Blood
Pulmonary Vein is O2-Rich, CO2-Poor
Alveolar Gas Equation
Partial Pressure of Alveolar Oxygen (PAO2)
Partial Pressure of Oxygen in the Inspired Air (PIO2)
PIO2 Normally Approximated = 150 mmHg
Arterial Partial Pressure of CO2 (PaCO2)
Respiratory Quotient (R)
R Normally Approximated = 0.8
PAO2 = PIO2 - (PaCO2/R)
Partial pressure of alveolar oxygen (PAO2)
Partial Pressure of Arterial O2 (PaO2)
Normal 10 to 15 mmHg
Hypoxemia with an Abnormal A-a Gradient
Shunting (Low V/Q)
Dead space (high V/Q)
Physiologic Dead Space (VD)
Tidal Volume (VT)
Partial pressure of arterial CO2 (PaCO2)
Partial pressure of CO2 in expired air (PECO2)
VD = TV x (PaCO2-PECO2) / PaCO2
Evaluates Respiratory Compensation
Used in Metabolic Acidosis
(HCO3 x 1.5 ) + 8 plus-minus 2 = PCO2
Bicarbonate (HCO3) x 1.5
= Expected Value for PCO2
Determines Transudative vs. Exudative Source of Pleural Effusion
Exudate if (At Least One of the Following):
Effusion/Serum Protein Ratio > 0.5
Effusion/Serum LDH Ratio > 0.6
Effusion LDH > Two-thirds Upper Serum LDH Range
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