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NCCU

  • normal EVD output
  • MELAS
  • scores for predicting ICH outcomes
    • ICH score: predicts mortality at 1 month
      • comprised of GCS, age> 80, ICH vol >30 mL, IVH, infratentorial hemorrhage origin
    • FUNC score: 90 day function
      • comprised of ICH volume, age, ICH location, GCS, pre-ICH cognitive impairment
  • calculating IVH size
  • Spetzler-Martin grading system for AVMs
  • digital subtraction angiography
  • Parinaud syndrome
  • bicaudate index
  • SAH grading
    • Hunt Hess
    • modified fisher
  • normal pressure perfusion breakthrough
    • AVM resection and BP goals
    • Hydrocephalus ex vacuo vs obstructive hydro

nimodipine used for vasospasm ppx for aneurysm-related SAH. Not clear re: AVM.

ICU Improvements

  • vent reporting
  • limit to ACTIVE, RELEVANT ICU issues
  • for A/P, ACTIVE ICU problem and status of what's keeping them here
  • MINIMIZE computer use
    • especially as you get to know patients
    • use primarily for DATA reporting (vitals, labs)
  • chronic issues (only ACTIVE, relevant ICU issues)
    • e.g., ACI, hypothyroid
    • “no acute issues”
  • “vital signs stable”
  • GFAP

To Read

RC711 .W469 2017, RC776.P87 P854 2004, RC756 .W45 2019

  • Alveolar Gas Equation

    $PAO2 = FiO2(P{atm}-P{H2O}) - \frac{PaCO_2}{RQ}$

substituting back in to $RQ$ equation: $RQ = \frac{P_ACO_2}{\frac{V_AP_ACO_2}{kVO_2}}= \frac{VO_2}{V_a}k$

$V_T = V_A + V_D$, where $V_A = 350$ and $V_D = 150$

Dead Space Fraction

$\frac{V_D}{V_T} = \frac{P_ACO_2 - P_ECO_2}{P_ACO_2}$

Formal measurement of $P_ECO_2$ requires volumetric capnography, which requires a capable ventilator or a dedicated measurement device.

Thankfull, $P_ECO_2 \approx ETCO_2$, so an approimation would $\frac{V_D}{V_T} = \frac{P_ACO_2 - ETCO_2}{P_ACO_2}$

Alveolar ventilation

$P_{A}O_2 = F_iO_2(P_{atm}-P_{H_2O}) - \frac{P_AO2}{RQ}$ $\dot{V}_A=k\frac{\dot{V}CO_2}{P_ACO_2}$ $\implies \dot{V}CO2 = \frac{\dot{V}_AP_ACO_2}{k}$

To convert $F_ACO_2$ into $P_ACO_2$, we have $F_ACO_2(P_{atm} - PH_2O = P_ACO_2$ Similarly, using $F_ECO_2$, we can show $P_ECO_2 = F_ECO_2(P_{atm} - P_{H_2O})$

$Volume_{expiredCO2} = Volume_{producedAlvCO2}$

$V_TF_ECO_2 = V_AF_ACO_2$

$V_TF_ECO_2 = (V_T - V_D)F_ACO_2$, and we can convert $F_ACO_2$ into $P_ACO_2$

learning_topics.txt · Last modified: 2024/11/15 19:16 by admin