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Index of critical parameters in the handbook
Oxygen status
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Oxygen uptake
Oxygen transport/delivery
Oxygen release
Lactate and tissue oxygenation
The patient's oxygen status - flow chart
Description of the flow chart
Oxygen partial pressure – pO2
- Reference interval pO2 – examples
- Physiological significance of pO2
- Why measure pO2 ?
- When should pO2 be measured?
- Clinical interpretation
- Causes of hypoxemia
- Symptoms associated with hypoxemia
- Causes of hyperoxemia
Hemoglobin – Hb
- Reference interval Hb – examples
- Hemoglobin: structure & function
- Why measure ctHb?
- Causes of decreased ctHb
- Symptoms of decreased ctHb
- Causes of increased ctHb
- Symptoms of increased ctHb
Oxygen saturation – sO2
- Reference interval sO2 – examples
- Physiological background – sO2
- Why measure sO2?
- When should sO2 be measured?
- Causes of decreased sO2
- Symptoms associated with decreased sO2
- Three ways of assessing sO2 in critically ill patients
Oxyhemoglobin – O2Hb
- Reference interval O2Hb – example
- What is O2Hb?
- Causes of decreased FO2Hb
- FO2Hb versus oxygen saturation (sO2)
Oxygen content – ctO2
- Reference interval ctO2 – examples
- Delivery of oxygen to tissue cells
- Why measure ctO2
- Causes of decreased ctO2
p50
- Interpretation of p50 values
- Reference interval p50 – examples
- The oxyhemoglobin dissociation curve (ODC) and concept of p50
- Reasons for determining p50
- Causes of increased p50
- Causes of decreased p50
- Diagnostic value of p50 – examples
Carboxyhemoglobin – COHb
- Reference interval COHb – examples
- What is COHb?
- When should COHb be measured?
- Causes of increased COHb
- Interpretation of COHb in cases of delayed measurement
- Blood oxygenation during carbon monoxide poisoning
Methemoglobin – MetHb
- Reference interval MetHb – example
- What is MetHb?
- When should MetHb be measured?
- Causes of increased MetHb
- Symptoms of methemoglobinemia
- Cyanosis in methemoglobinemia
Shunt
- Reference interval shunt – example
- Ventilation/perfusion ratio, dead space and shunt
- Why determine the FShunt?
- When should FShunt be determined?
- Interpretation guidelines for FShunt in critically ill patients fitted with a pulmonary catheter
- Causes of increased FShunt
- Symptoms associated with increased FShunt
Acid-base status
- The Siggard-Andersen acid-base chart
- Defining terms used in interpretation of acid-base status
- Acid-base flowchart
pH
- Reference interval pH – examples
- Why measure pH?
- When should pH (pCO2 and HCO3–) be measured?
- Causes of acid-base disturrbances
- Symptoms of acid-base disturbances
- Clinical interpretation
- Fetal scalp pH and umbilical-cord pH
- pH in pleural fluid
Carbon dioxide partial pressure – pCO2
- Reference interval pCO2 – examples
- Physiological significance of pCO2
- Why measure pCO2 ?
- When should pCO2 (pH and HCO3–) be measured?
- Causes of increased pCO2
- Causes of decreased pCO2
- Symptoms related to pCO2 imbalance
- Symptoms of increased and decreased pCO2
- Clinical interpretation
Bicarbonate – HCO3–
- Reference interval HCO3– examples
- Physiological significance of HCO3–
- Why measure HCO3–?
- When should HCO3– (pH and pCO2) be measured?
- Clinical interpretation
- Causes of decreased HCO3–
- Causes of increased HCO3–
- Symptoms related to HCO3– imbalance
- The distinction between actual and standard HCO3–
Base Excess – BE
- The concept of BE
- Reference interval cBase (Ecf) – examples
- Actual base excess (cBase(B) or ABE)
- Standard Base Excess (cBase(Ecf) or SBE)
- Why determine BE?
- Clinical interpretation
- Causes of abnormally negative BE
- Causes of abnormally positive BE
Anion Gap – AG
- Reference interval AG – examples
- Concept and clinical significance of AG
- Why determine AG?
- Metabolic acidosis and AG
- Clinical interpretation
- Causes of increased AG
- Causes of decreased AG
Potassium – K+
- Reference interval K+ – examples
- Distribution and physiological significance of potassium
- Why measure potassium?
- Physiological control of extracellular fluid potassium concentration
- Causes of hypokalemia
- Symptoms of hypokalemia
- Causes of hyperkalemia
- Symptoms of hyperkalemia
Sodium – Na+
- Reference interval Na+ – examples
- Distribution and physiological significance of sodium
- Why measure sodium?
- Sodium balance
- Terms used in interpretation of sodium
- Causes of hyponatremia
- Symptoms of hyponatremia
- Causes of hypernatremia
- Symptoms of hypernatremia
- A note on pseudohypo- and pseudohypernatremia
Chloride – Cl–
- Reference interval Cl– – examples
- Distribution and physiological significance of chloride
- Why measure chloride?
- Chloride balance
- Terms used in interpretation of chloride
- Causes of hypochloremia and hyperchloremia
- The value of chloride in the investigation of acid-base disturbance
- Causes of ”high-AG” acidosis
- Causes of ”normal-AG hyperchloremic” acidosis
- Acid-base disturbances associated with abnormal chloride
Ionized calcium – Ca2+
- Reference interval Ca2+ – example
- Distribution and physiological significance of calcium
- Why measure calcium?
- Regulation of calcium
- Terms used in interpretation of calcium
- Causes of hypocalcemia
- Symptoms of hypocalcemia
- Causes of hypercalcemia
- Symptoms of hypercalcemia
Glucose
- Reference interval glucose – examples
- Physiological significance of glucose and blood glucose regulation
- Why measure blood/plasma glucose?
- When should glucose be measured?
- Hyperglycemia and diabetes
- Hyperglycemia and the critically ill
- Causes of hyperglycemia
- Symptoms of hyperglycemia
- Hypoglycemia
- Causes of hypoglycemia
- Symptoms of hypoglycemia
- Hypoglycemia and neonates
- Causes of hypoglycemia in neonates include
Lactate
- Reference interval lactate – examples
- Physiological significance of lactate
- Why measure lactate?
- When should lactate be measured?
- Clinical interpretation
- L- and D-lactate
Bilirubin
- Reference interval bilirubin – examples
- Bilirubin metabolism
- Types of bilirubin found in plasma
- Why measure bilirubin?
- When should bilirubin be measured?
- Interpretation of bilirubin values
- Physiological classification of jaundice
- Physiological jaundice of newborns
- Treatment for hyperbilirubinemia/jaundice in newborns
- Action limits for treatment of newborns with jaundice
Creatinine
- Reference interval creatinine – examples
- Creatinine biochemistry and physiology
- Why measure creatinine?
- When should creatinine be measured?
- Clinical interpretation
- How is creatinine used to diagnose and stage AKI?
- How is creatinine/GFR used to diagnose and stage CKD?
- Symptoms of CKD
- Causes of CKD
- Nephrotoxic drugs
- Estimating glomerular filtration rate
- Estimating GFR equations recommended by NKDEP
Cardiac troponins – cTnI and cTnT
- Physiological significance of troponin
- Cardiac troponins and Myocardial Infarction
- When should cTnI/cTnT be measured
- Clinical indications for cTnI or cTnT request
- Defining a positive troponin result
- Troponin levels in patients suffering from MI
- Non-MI causes of increased cTnI and cTnT
Natriuretic peptides – BNP and NT-proBNP
- BNP and NT-proBNP – background physiology
- Specimen collection for BNP and NT-proBNP
- BNP and NT-proBNP in healthy individuals
- BNP and NT-proBNP for diagnosis of heart failure
- The prognostic utilization of BNP and NT-proBNP in HF
D-dimer
- What are D-dimers?
- D-dimer and venous thromboembolism (VTE)
- Causes of increased D-dimer not associated with VTE
- Why measure D-dimer?
- Clinical utility of D-dimer test not confined to VTE
- When should the D-dimer test be considered?
- Interpretation of D-dimer test results
C-reactive protein – CRP
- Background pathophysiology
- CRP reference values – what is normal?
- The distinction between CRP and hsCRP measurements
- Causes associated with increased CRP
- Clinical utility of CRP
Human chorionic gonadotropin – hCG
- hCG and its variants
- Background physiology – pregnancy and hCG
- Reference plasma hCG values
- hCG in the early diagnosis of pregnancy and early pregnancy loss
- Use of hCG in diagnosing ectopic pregnancy
- Monitoring role of hCG following pregnancy loss and ectopic pregnancy
- Causes of increased hCG outside of pregnancy