Info

🌱 來自: cardiovascular of clinical problem solvers

Hypoxemia

• frist ✅ is the pulseox on correctly
• 1st clincial clue
• does the O2 sat dramatcially improve with minimal O2

YES ⇒ see normal Aa gradient

• normal Aa gradient
• alveolar and vessel are communicating
• elevated PaCO2 drives decrease PaO2
• chronic obstructive pulmonary disease
• asthma
• opioid overdose

No ⇒ elevated Aa gradient

Listen, what do the lung says?

• normal breath ⇒ vessel problem
• abnormal 🙅 breath sounds ⇒ alveolar pattern

vessel problem

• blocked
  • pulmonary embolism
  • get CTPE
• bypassed?
  • Pulm: AVMs
  • Cardiac
    • patent foramen ovale
    • atrial septal defect/ventricular septal defect
    • get transthoracic echo w/ bubble

alveolar pattern

positive imaging findings on chest radiograph or chestCT

• pleural space

  • air: pneumothorax
  • fluid?
    • Light’s criteria
      • transudative
        • congestive heart failure
        • liver disease
        • end-stage renal disease
      • exudative
        • infection
        • cancer
        • autoimmune

• parenchymal: alveoli filled

  • blood 🩸: malignancy
  • pus: pneumonia
  • water: pulmonary edema