Blood Gases and Related Tests

Blood Gases and Related Tests

HISTORY

The patient is a 64-year-old female being evaluated for a liver transplant. She has a long history of liver disease and recently began to complain of increased shortness of breath. The shortness of breath seems to subside when she lies down. She has a smoking history of 55 pack-years. Spirometry revealed an FEV₁ of 1.23 L, consistent with a moderate obstructive ventilatory defect. She was referred for supine and upright shunt evaluation by the transplant surgeon.

 

PULMONARY FUNCTION TESTING

Personal data
Name:	C.B.
Age:	64
Height:	65.5 in
Weight:	135 lb
Race:	White

 

Shunt study
Supine
PB	763	PAo2	666
Fio2	0.989	a – ao2	243
Pao2	423	C(a –)o2	2.1
Paco2	34	QS/QT	26%
Sitting
PB	763	PAo2	670
Fio2	0.989	a –ao2	243
Pao2	304	C(a –)o2	1.6
Paco2	31	QS/QT	42%

TECHNOLOGIST’S COMMENTS

Actual C(a – )o₂ used for shunt calculation.

 

QUESTIONS

1. Interpret the sitting and supine shunt values.
2. What is the cause of the patient’s symptoms?
3. What other tests might be indicated?
4. On the basis of these findings, what treatment might be recommended?

 

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