Peri-anesthesia Monitoring and Complications IV

Oxygenation (SpO2)

HR

Change in SV

what does pulse ox show?

95%-90%

What is the acceptable range for SpO2?

PaO2 < 60mm Hg (90% SpO2)

When do we see hypoxemia?

Constant waves

Pulse rate matches HR

SpO2 is reliable when?

Motion

Pigment

Tissue perfusion

Tissue thickness

What can affect the SpO2's reliability?

Tongue

Lips

Toes

Toe nails

Where are you going to place a SpO2 probe?

Apply dry gauze to give cushioning effect

If the SpO2 reader is not working what can we do?

Dexoyhemoglobine less than or equal to 5g/dL

Can see at SpO2 = 80% (50mmHg PaO2)

What is the definition of cyanosis?

Adequate oxygenation

Pink MMC doesn't mean what?

Arterial blood gas analysis

What is the gold standard to measure PaO2?

Low FiO2

Hypoventalation

V/Q mismatch

Diffusion impairment

R-L shunt

What are the 5 causes of hypoxemia?

Increase O2 being given

-make sure o2 flow meter is on and O2 pressure is working

How do you tx low FiO2?

Ventilate more - too much CO2 in body

How is hypoventalition tx?

Prevent atelectasis and improve BP

What is important to do during an V/Q mismatch?

Large animals

What animals typically get a V/Q mismatch?

Pneumonia

Pulmonary edema

Pulmonary parenchymal dz

What is going to cause a diffusion impairment?

Patent foramen ovale

VDS

Pulmonary embolism

What are causes of a R-L shunt?

W/ mask

For 3 mins at (3L/min)

Continue until intubation complete

What should be done to pre oxygenate animals?

Slow titration- less resp depression

Small amounts at a time (wait 30-60s)

How should induction agents be given?

Brachycephalic dogs

What breeds are more susceptible to hypoxemia?

Keep intubated for as long as possible

Keep sternal

Keep monitoring SpO2

Prepare for reintubation

How should you recover a brachycephalic dog?

Pulseox wave - proportional to SV - bigger triangle = bigger SV

What is a plethysmograph?