On-Line Blood and Respiratory Gas Analysis

Data from a patient receiving ventilatory assistance are processed by computer to calculate pulmonary shunt, dead space/tidal volume ratio, oxygen uptake and delivery, and carbon dioxide elimination and delivery. The computations are based on routines described by Kelman and by Severinghaus, but modified to match limitations of testing imposed by the requirements for ventilatory assistance. Analyses are performed sequentially on arterial and venous blood samples and on respiratory gas samples. The output of the blood gas analyzers is fed on-line to a computer together with other data, such as patient identification, which are manually entered at a keyboard and with thumb-wheel switches. The computer processing begins with determining the concentration of oxygen and carbon dioxide in whole blood and of bicarbonate in plasma. The shunt equation is used to calculate a virtual shunt at therapeutic concentrations of inspired oxygen. Dead space/tidal volume ratios are corrected for mechanical dead space in the respiratory circuit. The analyzed results are returned to the operator within seconds via a video display. Since the data include blood samples from multiple patient sites, a cross-comparison is made by the computer and the operator is informed of unusually large differences in values.