Question

Mrs. Robochoue is in the neurosurgical intensive care unit following a motor vehicle crash in which he sustained a significant head injury. Because of increased intracranial pressure, he in in a pharmacologic coma. His body temperature is being maintained below normal to reduce the physiologic needs of the brain, and the ventilator is set to keep his pH slightly elevated and his PaCO2 below normal. In most patients, 90% is the low limit of acceptable readings for pulse oximetry.

Would the pulse ox value be the same for her, if so why and if not why not?

Will her hemoglobin release oxygen more readily at the tissue level or hang on to hemoglobin more tightly?

Answer 1

Intracranial hypertension is an important cause of secondary injury of patient with acute neurologic and neurosurgical disorders and typically madate specific monitoring.patient suspected intracranial blood pressure, should have monitoring cerebral oxygen extraction,as with jugular bulb oxymetry or brain tissue PO2,may also be indicated.brain injury patient have closely monitor of systemic parameters,including ventilation,oxyge oxygen,blood pressure,heart rate,temp tempera, intake and urine output.patient should monitoring routinely pulse oxymeter and capnography.

Hypercapnia is the elevation in the partial pressure of carbon di oxide(paco2)above 40 mm Hg.carbon di oxyde(co2) metabolic product of a many cellular process.which are responsible for the moderation of CO2 level.these include pH buffering system between hydrogen carbonate (HCO3) and CO2.due to this relation leads to acid base imbalance.

Coperatively enhance oxygen delivery by heamoglobin.Because coperatively between O2 binding site.heamoglobin deliver more O2 to tissue than would a non coperative protein.