Calculation of bidirectional shunts

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Information about Calculation of bidirectional shunts
Health & Medicine

Published on March 21, 2014

Author: ramachandrabarik

Source: slideshare.net

Description

Calculation of bidirectional shunt in cathlab

Calculation of Bidirectional Shunts Cross road both for examinee and examiner

Shunt Run • “Shunt Run” is performed if a difference of 8% or more is noted in blood sampling between chambers

Smaller physical, biggest physiological

Flamm’s

Flamm’s MVO2 • Average Oxygen Content in Chambers proximal to the Shunt • Method to calculate Mixed Venous Oxygen content • Need to factor in Contribution from IVC and SVC which is not equal • Flamm Equation: 3xSVC Oxygen Content + IVC Oxygen Content _____________________________________ 4

Dissolved O2

Fick Equation to Calculate Oxygen Content • Assumes in steady state that… that rate of substance entering (C in x Qflow) is equal to the rate of substance leaving (C out x Qflow) + the rate at which indicator, V, is added. Flow= Oxygen consumption/Arterial- Venous oxygen content difference • Where oxygen content is determined by automated methods • oxygen consumption is assumed based on patient’s age, gender and body surface area when not directly measured

Fick’s

Puzzles of 6 • MVO2 • PAO2 • PVO2 • SAO2 • QP • QS

Pulmonary Blood Flow

Systemic Blood flow

Qeff

In the Absence of Shunt in series •PBF=SBF=EBF

Left-to-right shunt • The approximate left-to-right shunt then = Q p - Q eff

Left to Right shunt

Left to right shunt

Effective Blood Flow • Fraction of Mixed Venous blood received by the lungs without contamination from shunt(from left to right)

Right-to-left shunt • the approximate right-to-left shunt equals Q s- Q eff

Right to left shunt

Just understand ,do not mug it up

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