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Formulas –
Part 2
Unwell Surgical Patient
Oxygen delivery
How to manipulate O2 delivery?
• DO2 = CO x Hb x SO2 x constant
• CO = SV x HR
• BP = CO x SVR
• DO2 = SV x HR x Hb x SO2 x constant
How to manipulate O2 delivery?
• DO2 = SV x HR x Hb x SO2 x constant
• SV ~ Preload (CVP) – Contractility – Afterload (SVR)
• HR ~ Slow – Irregular – Fast
• Hb ~ Blood loss – Chronic anaemia
• SaO2 ~ Ventilation – Perfusion
• Ventilation ~ FiO2 – RR – TV – Consolidation – Atelectasis
• Perfusion ~ PE – Hypovolemia
Oxygen–
hemoglobin
dissociation
curve
Ventilation
SaO2 vs PaO2 vs FiO2
• ALI the PaO2 (eg 10 kPa) /FiO2 (eg 0.2) ratio is <40 kPa (300 mmHg)
• Oxygen–hemoglobin dissociation curve (PaO2 vs SaO2)
Circulatory System
• Pump
• Vessels
• Blood
Shock
• Shock is the state of not enough blood flow to the tissues of the body
as a result of problems with the circulatory system (wikipedia)
Shock
• Cardiogenic (Pump)
• Hypovolemic (Blood)
• Distributive (Vessels)
• Obstructive (Vessels)

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Formulas - Physiology and Surgery