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2. a * .1; r" .4":T K:. - .6.- |. - .l,r A .5 li e h I |" i I l un I , _> vnw- mi:, .' 4. ..:7 n-a c"__ i, ' ,_r:v. '.. / 113.11 i. n v I l un.Veli.r:-. '.. / fs nr-y DvQ" _. _6 "'0 nini .. A yAntonini MV Terapia 1ntensiva I Anestesia e Rianimazione,AOU Parma - Blood Gas Analysis december 2013 35. jr:, 3 G "i 1;.s.41:ori gas ematici pH n00. P0. alori ossimetrici ciHb s0, F0,Hb PCOHb FHHb FMeiHbQ U4 6* se 7.377 44.8 mmHg 114 mmHg 9,5 gldL 29.3..-" 98,1 % 0.8 % 1.7 % 1.4 % CT uI i 7*.x_ ' ' _ l h.b J a t a wAntonini MV Terapia 1ntensiva I Anestesia e Rianimazione,AOU Parma Blood Gas Analysis december 2013r1 K 45. v zj fa at I a ' i r i i " '.i I . ' Lisa la sv. ',. ': esi" Valori gas ematci l ZpH 7,375pCO,46.9 rrW-gp0, 41.0 wri-aValori ossimetrecueiHb 9,4 91:-so! .1Poma 74.3 FCOHD 0,8 / - T FHHb 23.5 w.' FMetHD 1,4 u u..-'-Ab. ,7|, ._ V."da,f " " n"l "C" 91% f u x su;n1: 4|: Dv1l1"i. jnlvvvtlzs;" 36. v.i f:i ""a F 7 ".i:7?f r;.3 f.z ._ ,56; vi. _ " i! tu.,! un:5,- . - . .auh. .sn. l pH 7 400 Valori gas ematici pCOZ 40,2 mmHg pH 7-177 p0, 133 mmHo D002 83] mmHg ' p0, 36,7 mmHgalori ossimetrici ._ .. Valon ossnnetncuH B's 3m ctHb 8,7 g/ dL !_' " .'421: v X.. 3 r y- r :_f:" ""> " " i f- u_ .I I I '.x 4_u" |_, ,;' u%: -JM t: '-IAntonini MV Terapia Intensiva I Anestesia e Rianimazione,AOU Parma - Blood Gas Analysis dccembcr 2013 37. stesso pz 8: momentoS902 SvcO2 SjO2 (ESA)Antonini MV Enpia Intensiva I Anestesia e Rianimazione,AOU Parma - od Gas Ana ysis deccmber 20a; 38. SvO2: limitiIl existe des limiles dime rtation de la SvO2. Ces( une mesure globale qui ne prenal pas en compie une ventuelle souffrance tissulaire localise (ischmie msentrique,parexemple).Eaepem ae la position de la courbe de sdissociation de lHb (courbe de Barcroft).Pour une mme vzleur 5cImyperthennie,Fhypercapnie,Facidose,une augmemation du 2,3diph0sphoglycrate induisent un dpla-cement vers la droite de la courbe de Barcroft et diminuent ainsi la SVOZ de faeon indpendante des facteurs prcdemment dcdts.Enn,dans cenaines situations pathologiques,commele choc septique,Fextraction rhrne d;est altre.La SVO2 est alors evee,a ors que yper actatemie Iemoigne dune souffrance tssulairee " Blasco V et al,Ann Fr Anesth Reanim,2008 27(I):9 74-82 Antonini MV Terapia Intensiva 1 Anestesia e Rianimazione,AOU Parma - Blood Gas Analysis december 20x; 39. contenuto O202 dissolto + legatopia Intensiva I" Anestesia e Rianimazione,AOU Parma - Blood Gas Analysis decembcr 20x; 40. Antonini MV Terapia Intensiva I Anestesia e Rianimazione,AOU Parma Blood Gas Analysis december 20x; . 72-7). ' r. p-- ..'I"i Ii r "r" sui ' ' I ' - ) wc l ' i K, u -'5j' g i. -,(IU(_ vorja i ' - 7":r | l,_v: _i l,. l._;o} zf) .. . '- iv ria ' u u) la I (un 7.,r.fa m,i) _. 47A {: _. |I , ' f T r J . ,, J r. r!L c C;J. ' I'*"| .' f " i . ";un."r 37",54; a p,a |i,i " a.iI.r a I l;v.i i i i.I. "P"a-I n31": v-u. ". .. .-s4Q. -sw i ti"V 41. contenuto O,15 mL/ dL(PVOZ x 0.003) + (Hb x SVO2 x 1.34)Antonini MV Terapia Intensiva 1 Anestesia e Rianimazione,AOU Parma - Blood Gas Analysis decembcr 2013 42. trasporto O2 D02C2102 x COCO CO t t Antonini MV Terapia Intensiva 1 Anestesia e Rianimazione,AOU Parma - Blood Gas Analysis decembcr 20x; 43. ..n.1 - ,51! or.f! ; ',""" , "g e! l! E '|Il Il I,1r I ."v kl v 0.7x L r r r r p uv4 I 1 ' f1 '("Vi 1 ' |r i - 1|!1 4" __IA?.2r2 1x ,l, r; l.l'x-n s, -- ' eT"a"o't- l p:1 I,1_|, I'.1| 1 ' ' F, .3 f- r z'- I u. Antonini MV Terapia 1ntensiva I Anestesia e Rianimazione,AOU Parma Blood Gas Analysis december 20x; ,414 44. VO2 Fick principle- the theoretical principle devised by Adolf Fick in 1870, which states thai the total uptake or release of any substance by an or an is the product of blood flow to the organ concentration difference of thesubstance? T e c mica marker commonly used is oxxgen andthe difference between arterial and venous oxygen content is the uptake of oxzgen as it flows through the lungs" Jeremias A Brown DL, Cardiac Intensive CareAntonini MV Terapia Intensiva 1 Anestesia e Rianimazione,AOU Parma - Blood Gas Analysis decemgcr 20x; and the arteri0ven0us (A 45. "ria:h.i pg u _ I _ I 1 ' I.i:' 4: 1 k 1 1 .. ,| q Il;V " u! 1: n H z la!1 1 t- A I C r S n _ ,. I i .a " ;f i":' ;l:v i ' ma ,' a h:a y a ha i-"w - f,i L!. 14.1,) q} JAntonini MV Terapia Intensiva 1 Anestesia e Rianimazione,AOU Parma - Blood Gas Analysis decembcr 20x; O O 46. m r I's 74 .1 .4.5* s.r4 a [ 1 N ' ; ' i l | I g,.4, k , v I , _.. ,, "L .1 4 T";. N valori gas ematici u b i v ' pCO,39.3 mmHg p0, 108 mmHg -' j q jq- Q w- ' .i - r a '17","3 =_. Jr"'- .H).; - - r r}xLuaAntonini MV Terapia 1ntensiva 1 Anestesia e Rianimazione,AOU Panna - Blood Gas Analysis december 2013 47. . , y _.j l I |{a K I- .4s z n . a,, . ' I .3153 Zi] O S 3alori gas ematicnDH 7,403DCOZ 42,8 mmHgp0: 44,9 mmHg alon ossimetricrctHb 10,7 g/ dLu.q:. -' i r rei: A .4*u AQ_.(FAII,r.i ""( i i i i ' " ' || , ' i a - , , - |u I 1 u. Un q 1 " a In A.yl " i I . q,q" x i r ' J 4 ma d t.x e.xi1 i" ni x c n urcur 4': _ "prCyf gr 341' , -,4'|4I i |i i i g].i ;_.I Il . , . .vrw-s- un. . , ww-Antonini MV Terapia intensiva I Anestesia e Rianimazione,AOU Panna Blood Gas Analysis december 20r3 51. n'ai" J's" " su n" 4-3 c anca-u . - 4x5, 43.: . m hall, _' Ii I. r"-:z,', "i1lji| || Il!._ ti,I1, ... '-', 1(Ic', u1 In -u"r- . . IL5| ..0.. ..-"r&. ... r- . '. C, L 4t I;r 3,5 ,4' 'd'|1"[4ri A i '- [I I [il ' :-' ' l..4 ckn "PII '3" v5.0 l Il!c!"yl f I I C,-7 f rum-s- ung- a,4valori gas ematici f;a i., Mr ,- pHI,- | f . >,E)?I:pCO,71,5 mmHg i;v _} 3 po,77,3 mmHg i i T T. -.v,s r- n re "T,"N";. .i - .i i i v i i I |-.i I I i .I | u .I ' i .p I ai |I , ,, I L)l. 'i8' xul (a :3 qa " q'-r.1 ' V I .Q U T fa.l, ,.'_*e"" ' A;C_| ",'_j'ai , i apri.,I|i,l 1' i il l i '.i i I xi I. ,_.-'7"1_ - n 1g:4,,g, , ',_I_, , aria. Antonini MV Terapia intensiva I Anestesia e Rianimazione,AOU Parma - Blood Gas Analysis december 20r3 52. emogasanalisiequilibrio acidobase(adeguatezza)Antonini MV Terapia Intensiva 1 Anestesia e Rianimazione,AOU Parma - 53. Valori gas ematici pH n00.V,_Stato Acido Base cBase(Ecf), c cHCO, '(P. st). cA f. "N;. "I A";I.' I ' .g 56% g | -fl ._|I |LI z al ,"q, r-ci e,f r C e gS_ " iI '13 cit 54. r i |' ' i- *' i . " " u I 'i a f . . - .. - f 'I ' | I t i i- |,b- ,b:| I i ,' I F v 0' e l.. a x n "1 ul (r q ,-u rl- a T i, il i T T .J :_ _ m inma} r n a ' ' a .f?*, ' V 1 u" . | ' x i{oi V J,r" -I"r" "Fr i - ' ,I j I ' I|I" . ' I*' *' I A I i A i Il ,. ma -t| a"' L'. |;Antonini MV Terapia intensiva I Anestesia e Rianimazione,AOU Parma Blood Gas Analysis december 2013 60. pH normale? 7-35 < PH < 7-45 < NON alterazionid .d .t ntonini MV Tera ia Intensiva I" Anestesia c Rianimazione AOU Parma - Blood Gas Analysis dcccmbcr 2o 61. E '. . r:m,A a:r- g,a C,