Arterial Oxygen Tension in Relation to Age in Healthy Subjects

Sorbini, C. A.; Grassi, Vittorio; Solinas, E; Muiesan, G

doi:10.1159/000192549

Cited by 295 publications

(101 citation statements)

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“…Este deterioro de la distribución de la relación V'/Q' es consistente con la disminución de la PaO 2 en estas edades de la vida. Diversos estudios 25,[27][28][29][30] Los valores obtenidos con estas dos ecuaciones (Figura 2) se extrapolaron hasta los 80 años 31 . Sin embargo, las gasometrías en sujetos sanos de 90 y más de 100 años han detectado que en >70 a 75 años los valores de la PaO 2 medidos 30,33,34 , son mayores que los calculados por estas ecuaciones y que en edades >70-75 años, no existe una correlación significativa entre PaO 2 y los años de edad 33,34 (Tabla 3).…”

Section: Depuración Mucociliarunclassified

Función respiratoria en la senectud

2009

Rev. méd. Chile

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Section: Depuración Mucociliarunclassified

Función respiratoria en la senectud

2009

Rev. méd. Chile

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“…44 Alveolar gas exchange during anesthesia is less efficient in the elderly ( Figure 5B) and an inverse relationship exists between the increased age and arterial oxygenation in spontaneously breathing patients. 27,45 On the other hand, changes in chest wall and lung properties that accompany aging may actually help protect the elderly from anesthesia-induced changes in gas exchange. For example, atelectasis in dependent lung regions usually develops after induction of anesthesia.…”

Section: Mechanisms Of Postoperative Pulmonary Complicationsmentioning

confidence: 99%

Review article: Age related alterations in respiratory function — anesthetic considerations

Šprung

Gajic

Warner

2006

Can J Anesth/J Can Anesth

143

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Purpose: This review examines the effect of aging on pulmonary reserve. Special emphasis is placed on how anesthetic and surgical factors may impose substantial stresses on the respiratory system of elderly patients, leading to increased risk for postoperative pulmonary complications including respiratory failure.Source: A MEDLINE-based English-language literature search was undertaken for the period 1966-2006, and an EMBASE search covered the overlapping period 1988-2006. Selected articles were limited to those applying to elderly subjects/patients. Principal findings:Age-related loss of the lung static recoil forces, stiffening of the chest wall and diminished alveolar surface area lead to a decrease in vital capacity, an increase in residual volume, decrease in expiratory flows and increased ventilation-perfusion heterogeneity. Respiratory muscle strength consistently declines with age further increasing the work of breathing. While gas exchange may be well preserved at rest and during exertion, pulmonary reserve is diminished, and under conditions of positive fluid balance, positioning for surgery, and increased metabolic demand, postoperative respiratory failure can occur. Increased sensitivity to respiratory depressants and muscle weakness pose additional risks for the development of postoperative respiratory complications in elderly patients. Regional anesthetic techniques provide for superior postoperative analgesia, without necessarily altering the frequency of postoperative pulmonary complications in the older surgical population. Conclusion:Alterations in respiratory physiology associated with aging must be appreciated to anticipate and minimize potential complications associated with surgery and anesthesia in the elderly. Individualized care to optimize preoperative cardiorespiratory function, minimize intraoperative respiratory pertubations, and to gently restore postoperative pulmonary function are essential anesthetic goals for elderly patients who require surgery. Objectif

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“…18,19) A high alveolar-arterial oxygen gradient was assumed if the level was higher than the age-adjusted normal range. 19) Hypoxemia was defined when PaO 2 was lower than the age-adjusted normal range, 20) and hypocapnea when PaCO 2 was less than 35 mmHg. Electrocardiographic findings: A 12-lead electrocardiogram was obtained in both groups within 30 minutes after a patient's arrival in the emergency room.…”

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confidence: 99%

“…The alveolar-arterial oxygen (a-aO 2 ) gradient was calculated using the following equation: a-aO 2 gradient (mmHg) = 150 −1.25 PaCO 2 −PaO 2 (Eq 1) where PaCO 2 = partial pressure of carbon dioxide in arterial blood and PaO 2 = partial pressure of oxygen in arterial blood. 18,19) A high alveolar-arterial oxygen gradient was assumed if the level was higher than the age-adjusted normal range.19) Hypoxemia was defined when PaO 2 was lower than the age-adjusted normal range, 20) and hypocapnea when PaCO 2 was less than 35 mmHg. Electrocardiographic findings: A 12-lead electrocardiogram was obtained in both groups within 30 minutes after a patient's arrival in the emergency room.…”

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<b>A Simplified Clinical Model to Predict Pulmonary Embolism in Patients With Acute Dyspnea</b>

et al. 2006

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SUMMARYThe objective of the present study was to develop a simple clinical model for predicting pulmonary embolism (PE) in patients with acute dyspnea in the emergency room.Patients and measurements: We enrolled 56 patients diagnosed with PE, and 92 consecutive patients without PE, all of whom presented with acute dyspnea in the emergency room. Primary emergency-room physicians assessed the initial evaluation and interpretation of various laboratory findings. Some significantly independent predictors of PE were identified and integrated into a clinical model of pretest probability: low (< 30%), intermediate (≥ 30%, ≤ 70%), and high (> 70%). After setting up the model, another 40 patients (16 with PE, 24 without PE) were tested using the pretest model.Clinical variables associated with an increased likelihood of PE were being female and having unilateral low-leg edema, a high alveolar-arterial oxygen gradient, a clear chest x-ray, and electrocardiographic findings of right ventricular strain. Variables associated with a decreased likelihood of PE were cough, chest tightness, and unclear breath sounds. Our clinical model predicted that 95% of patients with PE had a high or low probability of PE. The positive predictive value for high probability was 94.1% and the negative predictive value for low probability was 94.4%. In the tested group, the positive predictive value for high probability was 92.9%. The negative predictive value for low probability was 91.3%.This simple and easily available prediction model was useful for estimating the pretest probability of PE in patients with acute dyspnea. (Int Heart J 2006; 47: 259-271) Key words: Pulmonary embolism, Acute dyspnea, Pretest probability PULMONARY embolism (PE) can lead to early death or serious morbidity. [1][2][3][4][5] Early diagnosis and appropriate management can decrease the mortality and morbidity.6-12) Therefore, a simple and readily available clinical indicator for primary physicians to accurately predict the probability of PE will be beneficial and is necessary. Previous 13-16) structured clinical models for early pretests of the proba- [13][14][15][16] placed relatively large proportions of patients in the intermediate probability category, which was of limited utility to both physicians and patients. Furthermore, previous models used suspected PE instead of specific symptoms as the initial inclusion criterion for patient recruitment. [13][14][15][16] This criterion, however, lacked a clear definition because, in part, different physicians had different perceptions of suspected PE. These models, therefore, led to heterogeneous populations predicted to have PE, which undoubtedly led to variable pretest probabilities [13][14][15][16] and the low accuracy of these models. 14-16) Consequently, these models were of limited value in clinical practice.The purpose of this study was to determine the efficacy of a clinical model integrating simple and readily available clinical parameters, viz. symptoms, physical findings, and the results of chest x-ray, e...

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Arterial Oxygen Tension in Relation to Age in Healthy Subjects

Cited by 295 publications

References 24 publications

Función respiratoria en la senectud

Función respiratoria en la senectud

Review article: Age related alterations in respiratory function — anesthetic considerations

<b>A Simplified Clinical Model to Predict Pulmonary Embolism in Patients With Acute Dyspnea</b>

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