Question

In: Anatomy and Physiology

Raymond Harrison, a 64 year old male, was admitted to the hospital with fever (101.8 F),...

Raymond Harrison, a 64 year old male, was admitted to the hospital with fever (101.8 F), shaking chills, a nonproductive cough, and chest pains. A chest X-ray revealed extensive accumulation of fluid in both lungs. The patient had mild hypertension (high blood pressure) of 150/90 (normal would be 120/80) and a smoking history of 275 packs per year. The patient was cyanotic (looked blue) and in respiratory distress. The patient's heart rate was elevated at 100 beats per min (normal would be 60-80 ppm).

An arterial blood gas test was performed, and the oxygen saturation of the atrial blood was 72% (normal would be 90-100%). The blood test also revealed an elevated white blood cell count. Initial treatment consisted of antibiotics and bronchodilators.

  1. An atrial "blood gas test" was performed to measure oxygen levels. Explain why the blood was taken from an artery and not a vein.
  2. In the blood gas test, the oxygen measurement is reported as saturation. How is the oxygen carried in the blood, and what exactly is being saturated with oxygen.
  3. Why does this patient have low oxygen saturation? What is preventing him from having saturation in the normal range?
  4. How does the abnormal oxygen saturation value relate to the patient's cyanotic (blue) appearance?
  5. How does the abnormal oxygen saturation value related to the patient's elevated heart rate?

Solutions

Expert Solution

  • The blood for the blood gas test was taken from the artery and not from the vein. This is because arterial blood is oxygenated ( oxygenated from the lungs and transports to the tissues for supply oxygen and other essential nutrients to the tissues for metabolism). Arterial blood is saturated with oxygen. Whereas venous blood is deoxygenated blood. The level of oxygen in the venous blood is low. So in order to check the oxygen saturation, arterial blood is used. This represents the efficiency of lungs gas exchenge.
  • There are two ways of oxygen transport.
    • as dissolved oxygen ( small amount )
    • as oxyhemoglobin nearly 98 percent ( that is oxygen is bound to the protein hemoglobin in the red blood cells)

Oxygen is attached with the hemoglobin in the RBC of blood and transports to the various parts of the body. A fully saturated oxyhemoglobin ( HbO2) contains four oxygen molecules. The ability of hemoglobin to bind to O2 is influenced by the partial pressure of oxygen. The greter the partial pressure of oxygen, more readily oxygen binds to the hemoglobin

  • This patient is having low oxygen saturation because he is having pleural effusion( thai is fluid filled in the lungs). Gas exchange worsens with pleural effusion. Thereby the oxygen availability in the blood also decreases. so the oxygen availability in blood to bind with hemoglobin also decreases. this causes low oxygen saturation
  • When the oxygen binds with hemoglobin forms oxyhemoglobin, which provides the bright red colour to the oxygenated blood in the arteries. Whereas decreased oxyhemoglobin in the venous blood makes the blood colour as dark red. Abnormal oxygen saturation value means low oxygen level in the blood and this lack of oxygen causes the bluish discoloration(cyanosis)
  • This patient is having increased heart rate associated with the low oxygen saturation. This is a compensatory mechanism of the body. As the oxygen level in the blood decreases the heart pumps more to compensate the oxygen inavailabilty. Thereby increase the oxygen level in blood

Sydney Mullin answered 1 year ago
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