- Venous Blood Gas: Useful to screen for hypercarbia (not hypoxemia). If elevated, will need an ABG.
- RVSP on TTE: Estimation is with large S.E. - need RHC to formally evaluate
- If RVSP >50 unlikely acute process since this degree of elevation in pressures acutely would cause RV failure and HD compromise
- Shunt Physiology: Increasing FiO2 will only result in minimal improvement in PaO2. With serial ABGs on different O2 settings can actually calculate shunt fraction.
- Intrapulmonary Shunt Examples:
- Hepatopulmonary Shunt
- Hereditary hemorrhagic telangiectasia
Posted 07/25/16 02:16:36 PM by Adam Faye
Pulm HTN Groups:
- PAH (idiopathic, connective tissue disorders, drugs and toxins)
- Secondary to Left Heart Disease
- Secondary to chronic lung disease and/or hypoxemia
Posted 07/25/16 02:22:35 PM by Adam Faye
- Group 1 PAH - administer inhaled NO. See if Mean PA decreases by >10mmHg to a value less than 40 mmHg. If positive trial a calcium channel blocker - untreated median survival of 2-3 years
- V/Q scan for diagnosis (more distal emboli which CTA can have difficulty picking up).
Posted 07/25/16 02:24:34 PM by Adam Faye
Posted 07/25/16 02:31:07 PM by Adam Faye
Created by Christopher Kelly
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