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Hyperoxyc test in man

This detailed overview explores hyperoxia, ventilation under extreme pressure conditions, and the physiological effects of oxygen in various environments, including high altitudes and deep diving. It highlights the concept of partial pressure, the significance of hyperbaric oxygenation in treating conditions such as carbon monoxide intoxication, air embolism, and non-healing wounds. The document also discusses the right-to-left shunt in pulmonary circulation, techniques for measuring oxygen saturation, and offers insights into the clinical cases related to ventilation/perfusion imbalance.

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Hyperoxyc test in man

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  1. Hyperoxyc test in man MUDr. Dobroslav Hájek, CSc. MUDr. Michal Jurajda

  2. The atmosphere • N2 78,1% • O2 20,9% • CO2 0,03% • noble gases 1%

  3. Concentration of gases • Partial pressure- pressure of the given gas in the mixuture of gases.

  4. atmospheric pressure ????

  5. Ventilation under extrem pressure conditions • High altitudes – low pressure • Diving – high pressure • Remember: optimal pO2 cca 21 kPa

  6. Hyperbaric oxygenation • - increases physically dissolved oxygen in blood and tissues

  7. Hyperbaric therapy is used in: • CO intoxication. • Air embolism. • Decompression. • Anaerobic infections. • Non healing wounds

  8. Hemoglobinu saturation

  9. Oxygen measurements • saturometer – saturation of Hb (%) • oxymeter - paO2 (Pa) lung function Fi O2 paO2

  10. Right to left shunt • Hypothetical fraction of blood flow (right ventricle output) passing the lungs without beeing oxygenated.

  11. Right to left shunt • Anatomical • Functional

  12. Functional

  13. Dead space The dead space (alveoli with low ventilation/perfusion ratio) incrase the right-to left shunt.

  14. paO2 = S.pvO2+(1-S).piO2 • paO2 = S.pvO2-S.piO2+ piO2 • S.pvO2-S.piO2 = paO2-piO2 • S.(pvO2-piO2) = paO2-piO2 • S = (paO2-piO2)/(pvO2-piO2) • S = (piO2-paO2)/(piO2-pvO2)

  15. Remember • When the increased right-to left shunt is caused by vascular bed involvement (typically: lung embolism) the response of partial oxygen pressure in arterial blood (paO2)to oxygen administration is very poor. (The paO2 increase is very low when oxygen is administered)

  16. Clinical cases • Poisoning by hyptotic or sedative drugs (e.g. barbiturates, benzodiazepins, morphin) • Foreign body (corpus alienum) in bronchus with its obstruction • Ventilation/perfusion unbalance.

  17. The objective • Estimate rght to left shunt

  18. Material • Transcutaneous oxymetr • Medicinal oxygen in gas bottle with pressure reduction valve and flow regulation valve. • Mask with gas blender and delivery hose

  19. Leland C. Clark

  20. The method • Increasing FiO2 increases paO2 • paO2 can be measured in arterial blood or in arterialised capillary blood by transcutaneous oxymeter (heated electrode). • The incerease of paO2 is dependent on FiO2 and right to left shunt.

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