The significance of a change in Pa02 occuring in a patient with
cardiovascular instability cannot be ascertained unless the values
for PV0 and CV02 are known. A fall in Pa02 could 2 reflect
worsening of pulmonary function or deterioration of cardiac output
(with resultant increase in systemic oxygen extraction). PEEP/CPAP
would be an appropriate therapy in the former case but frankly
deleterious in the latter if applied prior to cardiovascular
stabiliza- tion. References 1. Douglas ME, Downs JB, Dannemiller FJ
et al (1976) Change in pulmonary venous admixture with varying
inspired oxygen. Anesthesia and Analgesia 55:688-695 2. Kelman GR,
Nunn JF, Prys-Roberts C et al (1967) The influence of cardiac
output on arterial oxygena- tion. A theoretical study. Br J Anaesth
39:450-458 3. Kirby RR (1986) Respiratory vs cardiovascular
dysfunction - How can we differentiate? ASA Refresher Course
Lectures, 102 4. Nunn JF (1977) Applied respiratory physiology (2nd
ed). Butterworth et Co 5. Van Aken H, Lawin P (1981) Der EinfluB
des Herzminutenvolumens auf die arterielle Oxygenation.
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