Download PDF by Garrioch, Magnus: Anaesthesia

By Garrioch, Magnus

ISBN-10: 184076077X

ISBN-13: 9781840760774

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Partial pressure of oxygen in mmHg/kPa. ii. Saturation (0–100%). The y-axis might also be expressed as oxygen content. When the Hb level is 15 g/100 ml the scale runs from 0–20 ml oxygen/100 ml blood. iii. Increases in H+ (acidosis), CO2, temperature and 2-3 di-phosphoglycerate. iv. A right shift of the oxygen–haemoglobin dissociation curve increases O2 release from haemoglobin molecules. Note that increased delivery (unloading) of oxygen is aided by products of increased metabolism so that local metabolism (see iii) increases O2 supply without increasing cardiac output.

Iii. What rapid test can be used on an anaesthestic machine to test if the ventilator pattern is the cause of the hypotension? iv. How is this diagnosed with a typical ICU ventilator, and why is this important? indd 53 15/10/14 11:37 AM Answer 40 40 In the ‘ideal lung’ PaCO2 and ETCO2, ventilation and perfusion should match exactly with a ratio of 1. e. a spread of V/Q ratios) leads to alveolar dead space and a difference between PaCO2 – ETCO2. Two factors are important here: • Gravity causes variation in alveolar size.

This patient’s angiogram (21b) shows a typical tear (arrow) at the junction where the ductus arteriosis existed 21b embryologically and inserts into the aorta alongside the superior aspect of the pulmonary artery. This is the weakest point along the aortic arch. Only the adventitial layers are preventing a massive bleed from this point of the rupture. indd 28 15/10/14 11:37 AM QUESTION 22 22 This lady (22) has presented to internal medicine with worsening of chronic shortness of breath. She reports that she has had ‘heart trouble’ for some time and has refused heart surgery due to anxiety.

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Anaesthesia by Garrioch, Magnus


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