Here is a 10-minute video I made for the Cooper Critical Care Conference. It explores some basic & useful concepts about hypoxemia physiology, including how to apply this at the bedside. The algorithms in the video aren't intended to be strictly followed, but rather merely as general conceptual schemas.
related
- For more information about the disutility of ABGs in evaluating the cause of respiratory failure, see this prior blog.
- A more detailed discussion about hypoxemia physiology in the context of shunting may be found here.
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Hi Josh. I know for a long time by reading you that you “dislike” ABG. One comment and one question :
Thanks for the post
Dear Josh, Thank you very much for this talk. I had a recent case of a large pulmonary embolism with refractory hypoxaemia (at Janus General). Haemodynamically the patient was relatively stable – tachycardic but with a acceptable BP. We decided on half dose thrombolysis – and she improved markedly over several hours. This would apparently be at odds with the message of your talk – but in actual fact is not. The hypoxaemia would be due to the development of an intracardiac shunt. Acute pulmonary hypertension would lead to an intracardiac shunt over a previously asymptomatic patent foramen ovale. I… Read more »