Formulas related to O2

transport

Fiona Campbell BS, RRT-NPS

Spring 2008
 Oxygen content of arterial
blood (CaO2)
 Calculated by adding the volume of oxygen
dissolved in the plasma and the volume of
combined oxygen
 O2 Dissolved in Plasma
 PaO2 X solubility coefficient of O2
 100 mmHg X .003 vol%/mmHg = 0.3 vol%
 O2 combined with Hb
 Hb X 1.34 X SaO2
 15 X 1.34 X .97 = 19.5 vol%
 CaO2=O2 dissolved in Plasma+O2 combined with Hb
 CaO2 = 0.3 vol % + 19.5 vol % = 19.8 vol %
Oxygen content of mixed
venous blood (CvO2)
 Blood returning to the heart will have a
lower content
 Normally PvO2 is approx 40 mmHg and
SvO2 is normally 75%
 The most accurate PvO2 is drawn from
the pulmonary artery
 CvO2 = (PvO2 X .003) + (Hb X 1.34 X SvO2)
 CvO2 = (40 mmHg X .003)+(15 X 1.34 X .75)=15.2 vol%
Arterial-Venous O2 content
difference C(a-v)O2
 The C(a-v)O2 measures oxygen
consumption of the tissues
 C(a-v)O2 = CaO2 – CvO2
 C(a-v)O2 =20 vol% - 15 vol% = 5 vol%

 C(a-v)O2 difference will when

CvO2 & indicates a cardiac
output
Factors that effect C(a-v)O2
INCREASE DECREASE
Decreased Cardiac Increased Cardiac Output
Output
Periods of increased O2 Skeletal relaxation (i.e.-
consumption induced by drugs)
i.e. - Exercise, Seizures Peripheral shunting (i.e. –
sepsis, trauma)
Shivering in Post-Op Certain Poisons
(i.e. – cyanide prevents
cellular metabolism
Hyperthermia Hypothermia
Alveolar Gas Equation (PAO2)

Partial Pressure of O2 in the Alveoli

 PAO2=[(PB – PH2O)FiO2] –[PaCO2/(RQ)]
 PAO2 = [(760 – 47).21] – [40 /(0.8)]
 PAO2 = [149.73] – [50]
 PAO2 = 99.73 mmHg
Alveolar-arterial oxygen
gradient P(A-a)O2
 The difference between the amount of O2
that enters the alveoli and the amount that
gets to the blood stream
 Non-invasive bedside tool used to quantitate
the efficiency of oxygen loading
 An increase in P(A-a)O2 indicates an
increase in shunt
 PAO2 – PaO2 = P(A-a)O2
a/A ratio
 Represents the percent of alveolar O2
that reaches the blood stream

 a/A ratio = PaO2/PAO2

 a/A ratio = 55/100 = 0.55 or 55%

 An a/A ratio of 75% is considered

acceptable
Predicted PaO2
 Comparisons of O2 in the lung and O2 in the
bloodstream can be formulated using P(A-a)O2 and
a/A ratio

 These formulas can also be used to predict a PaO2

when the FiO2 needs to be altered

 By understanding the relationship of the PAO2 and

PaO2, one can properly treat the patient
 Selecting an incorrect FiO2 one can over-correct or
under-correct hypoxemia
Predicted PaO2
 Formula:
Current PaO2 = Desired PaO2
Current FiO2 = Desired FiO2
 This formula works only if other factors that effect
his ventilation or metabolism are not involved
 Solve for X
72 torr = 86 torr
.30 X

72X = .30(86)
X = .36 or 36% * The FiO2 must be increased to achieve
the desired PaO2 of 86 torr
Predicted PaO2
 This formula can be proven with other formulas
learned:
 With given PaO2 = 76 torr, PCO2 = 40 torr, FiO2 30% :
 PAO2 = 163.9 torr
 a/A = 72 torr/163.9 torr = 0.44 or 44%
 Now with the FiO2 raised to 36% the PAO2 rises to
206.68 mmHg, 44% of O2 will get to the bloodstream and
the predicted PaO2 is approx. 90 mmHg

 NOTE: The ratio is for estimations and not absolute, by being

aware of this relationship, one can quickly asses the oxygen
requirement for the patient