Info

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