Texts: Respiration Section HW 1 (16 points max)
1. (5) The following data was collected in a patient with respiratory failure:
VE MRCO2 PaCO2 PetCO2 L/min mL/min mm Hg mm Hg BTPS STPD
15.6 199 32 18 Pulmonary edema
Assume: Body temp=37 deg C, PH2O = 47 mm Hg, B=760 mm Hg
a. (1) Convert MRCO2 from (mL/min STPD) to (L/min -BTPS)
b. (1) Calculate FECO2 based on MRCO2(L/min-BTPS)=VE (L/min-BTPS)*FECO2
c. (1) Calculate PECO2
d. (1) Calculate Vd/VT using Vd/VT=(PACO2-PECO2)/PACO2 for PACO2= PaCO2
e. (1) Using VE*FECO2=VA*FACO2 and FACO2= PACO2/ (B-47) calculate VA=alveolar ventilation
2. (4) Spirometer volume measurements are made in units of ATPS (ambient temperature and pressure, saturated with water vapor at the ambient temperature). Volume measurements can be used to measure lung volumes or metabolic rate from timed volume change measurements. ATPS values must be converted to BTPS (body temperature (generally 37 deg C), ambient pressure, and saturated with water vapor at body temperature) or STPD (0 deg C, 760 mm Hg barometric pressure, and dry) - used for metabolic rates and diffusion capacity measurements. A volume measurement of 4 liters ATPS is made (25 deg C, barometric pressure B=14.9 psi (Death Valley), saturated with water vapor at 25 deg C).
a) (2) Calculate this volume in BTPS (body temperature 37 deg C, saturated with water vapor at 37 deg C).
b) (2) Calculate this volume in STPD units.
PH20(25)=23.8 mm Hg PH2O(37)=47 mm Hg
3. (7) A patient with mild lung disease spontaneously breathing at sea level maintains an arterial PaCO2 of 47 mm Hg.
a) (2) If this patient is in an airplane where the barometric pressure is 565 mm Hg, use the alveolar equation to estimate PAO2 assuming body temperature is 37 deg C. Assume R=.85.
b) (2) Calculate what inspired fraction of oxygen is needed to raise PAO2 to 100 mm Hg.
c) (3) If the patient inspired ventilation is 10 L/min and PIO2 has to increase by 30 mm Hg, calculate the constant delivery rate of 100% oxygen for a net inspired fraction of .3 if half of the oxygen flow is wasted during expiration.
Note: What is assumed is a mild case of lung disease where alveolar PACO2 can be assumed equal to arterial. This would be a patient who does not have to be put on supplemental oxygen continuously at sea level.