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Investigaciones Andina
Print version ISSN 0124-8146
Abstract
MENDIETA IZQUIERDO, Giovane; GARCIA MUNOZ, Ana Isabel and ROMERO DIAZ, Sol Angie. INTRAPULMONARY SHUNT, ALVEOLAR- ARTERIAL INDEX AND ALVEOLAR -ARTERIAL OXYGEN GRADIENT PRIOR NON-INVASIVE MECHANICAL VENTILATION. Investig. andina [online]. 2016, vol.18, n.33, pp.1697-1708. Epub June 16, 2015. ISSN 0124-8146.
Objective.
Describe the behavior of the alveolar-arterial oxygen gradient (Grad [Aa] O2), arterial- alveolar oxygen index (Ind [aA] O2) and Intrapulmonary shunt (Qs / Qt) in a patient group prior to ventilation -VMNI- in an intensive care unit -UCI-.
Methodology.
Retrospective cross-sectional study. We calculate the Grad[A-a] O2 by the equation: PAO2 = [[(pAtm-pH2O) xFiO2] - (pCO2 / RespQ)] - PaO2], for: Res-pQ = (0,8); (PAtm = 560mmHg for Bogotá, which is 2640 meters above sea level); PH 2 O = (47 mmHg); The (Ind [a-A] O2) and (Qs / Qt) with the formula: (Cco2-Cao2) / (Cco2-Cvo2). Scope: Tertiary Hospital. Patients: 16 ICU subjects using a non-probabilistic consecutive sample, who received NIMV in a 3-month measurement period. Variables of main interest: Diagnosis, age, blood gas analysis, the variables were: (Grad [A-a] O2), (Ind [a-A] O2) and (Qs / Qt).
Results.
The mean age of the study population was 59.6; of these, 56% (n = 9) were women. NIMV was used in 14% (n = 16) of patients with a total population of 116 over a three-month period. The gasometric values found were: (Ind [aA] O2) = (0.38mmHg ± 0.2mmHg), (Qs / Qt) = (25% ± 8.1%) and (Grad [Aa] O2), PaO2 42mmHg ± 15mmHg), PaO2 / FiO2 = (149 ± 44.2), SvO2 (n = 8) = (66.2% ±) 9.3%), PH = (7.38 ± 0.1), SaO 2 = (92% ± 2.8%) and PaO 2 (70 mmHg ± 15.4 mmHg).
Conclusions.
The gasometric values (Qs / Qt = 25 ± 8.1%), (Ind [aA] O2 = <0.38 ± 0.2 mmHg) and (Grad [Aa] O2 = 159 ± 64.1 MmHg), identified in this group of patients, can be taken into account prior to the onset of NIMV in subjects with similar characteristics at a height of 2,640 meters above sea level.
Keywords : artificial respiration; blood gas analysis; critical care.