Physiologic Shunt - Siemens Rapidlab 1200 Operator's Manual

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Rapidlab 1200 Operator's Guide: System Overview and Intended Use

Physiologic Shunt

The physiologic shunt [ sp/ t(T)] is that portion of the cardiac output entering
the left side of the heart that does not perfectly respire with the alveoli. The shunt
calculation represents the best available means of delineating the extent to which
the pulmonary system contributes to hypoxemia.
The system determines the physiologic shunt using the following equation:
sp/ t = [(ctO
where
ctO
(c) = [OBF x tHb × (1–FCOHb–FMetHb)] + (0.00314 × A)
2
A = [(F
pH
O = 10
2
and the ( ) in ctO
NOTE:
OBF is the oxygen binding factor. The system uses the default value of 1.39, or
whatever value is entered as the default value in Setup.
Estimated Shunt
Pulmonary artery blood gases are not always readily available, but a need to
determine changes in the physiologic shunt may still exist. The best alternative
method for reflecting changes in the physiologic shunt is the estimated shunt
[ sp/ t(est,T)] value, which is applicable to most hypoxemic patients with
cardiovascular stability.
The system determines the estimated shunt using the following equation:
sp/ t(est) = [(ctO
100
where
ctO
(c) = [OBF × tHb × (1–FCOHb–FMetHb)] + (0.00314 × A)
2
A = [(F
pH
O = 10
2
For ctO
whatever value is entered as the default value in Setup.
(c)–ctO
(a)) / (ctO
2
2
O
/100) × (pAtm–pH
I
2
2
[(0.0244 x temp) + 0.7655]
(a- ) is for a mixed venous sample.
2
If the F
O
value is not at least 40, the shunt cannot be calculated.
I
2
9
(c)–ctO
(a)) / ((ctO
2
2
O
/100) × (pAtm–pH
I
2
2
[(0.0244 x temp) + 0.7655]
(a- ) entered, the system uses the default value of 3.5 mL/dL, or
2
9
(a- ) + ctO
(c)–ctO
2
2
O)]–{pCO
(T) × [1.25–(0.25 × F
2
+ 0.4
(a- ), entered) + ctO
2
O)]–{pCO
(T) × [1.25–(0.25 × F
2
+ 0.4
1-63
(a))] × 100
2
O
/100)]}
I
2
(c)–ctO
(a))] ×
2
2
O
/100)]}
I
2
02087462 Rev. V

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