Show your work and explain. Someone has blood work done at 10 a.m. with the foll

Question

Show your work and explain. Someone has blood work done at 10 a.m. with the following results: hemoglobin concentration as 14 g/dL blood (1dl-100mL), SaO2 of 98%, PaO2 of 100 mm Hg. At 10:30 am, they suffers a severe hemolytic incident that drops her hemoglobin to 7 g/dL a) What happens to her PaO2 (increase, decrease, no change)? Why? b) What happens to her arterial hemoglobin 02 capacity (cap Hbo2) (increase, decrease, no change)? Why? c) What happens to her arterial O2 content (CaO2) (increase, decrease, no change)? Why? d) What happens to her O2 delivery rate if her cardiac output is 5 L/min Solubility of O2 in blood is 0.003 mL/100 mL blood/mm Hg; 1 g Hb can bind 1.34 mL O2

Explanation / Answer

a. Pa O2 may decrease,

PaO2 is the partial pressure of oxygen dissolved in (arterial) blood. The hemolytic event will decrease the RBCs or Hbs in blood circulation, which will eventually decrease the Oxygen binding capacity of blood.

b. CapHbO2 decreases:

Arterial Hb Oxygen capacity is the measured value of the ability of Hb to bind O2. Usually, one Hb binds to 4 O2 molecules.

In hemolysis, the Hb also decreases and oxygen binding capacity also will be the same.

c. CaO2: Decreases (arterial oxygen)

CaO2 = ((Hb x 1.39) x SaO2/100) + (PaO2 x 0.003).

Initial CaO2= (14 x 1.39 x 98) + (100 x 0.003)

1907.08 + 0.3 = 1907.38 L/dl

i.e= 19 ml/dl/mm of Hg

The decrease in Hb , PaO2 and SaO2 causes a depletion in CaO2

d. O2 delivery rate: decreases with decrease in CaO2

Cardiac output = 5L/min

Solubility of O2 in blood = 0.003 ml/dl blood/mm Hg

1gm Hb is capable of carrying 1.39 mL of oxygen

Formula to calculate ,O2 delivery rate, DO2 = Cardiac Output x CaO2 x 10

DO2 = 5 x 19 ml/dl x 10

= 950 ml initially before hemolytic event

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