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