Respiratory Therapy - A-a Gradient, a/A ratio, how they apply and why it matters?

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  • เผยแพร่เมื่อ 30 ส.ค. 2020
  • Understanding that arterial oxygenation depends on the efficacy of the alveoli explains alot. Why does A-a gradient increase when breathing 100% oxygen? Is this a bad thing? Let me know what you think at the conclusion of the video! Thanks for watching!!!
    Don't forget to email me to find out how to get a shirt! respiratorycoach@gmail.com
    Please subscribe, like and comment. Would love to hear what you think about the video. Also look for me on social media....
    TIK TOK @respiratorycoach
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    Feel free to email me any questions or concerns @ respiratorycoach@gmail.com.
    BEST WISHES!!!
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ความคิดเห็น • 38

  • @hardnoodle
    @hardnoodle 3 ปีที่แล้ว +12

    Coming up on my 1 year mark as a respiratory therapist. These videos are still helpful even to a Registered RT. Never stop learning!

    • @RespiratoryCoach
      @RespiratoryCoach  3 ปีที่แล้ว

      NEVER....EVER...you'll be amazed at how much you can continually learn for the sake of improving your patient care and outcomes!!!

    • @sumbulkamal9950
      @sumbulkamal9950 3 ปีที่แล้ว

      I am respiratory therapist in Pakistan i need your help and your all vedio and some type of presentation which help me in my job if you send me through my email

  • @JustinJayBeats
    @JustinJayBeats 3 ปีที่แล้ว +2

    Hey sir. Just wanted to let u know that your channel is the best. I learned a lot from you videos that really helped me in my clinicals. Gave me that edge with all the extra knowledge. You made a video about my question a year back about aprv. I haven't had a chance to reach back because I've been busy working after graduation. I'm happy to see your channel grown to 20k subs...def well deserved and I knew your channel would blow up. I hope you keep putting out more content, because even now I'm in the field in an acute setting, I'm still learning from your videos!

    • @RespiratoryCoach
      @RespiratoryCoach  3 ปีที่แล้ว

      You're awesome, Justin. So glad to hear you are out and working post graduation. Thank you for the continued support!!! Never forget.. AVERAGE IS EASY!!

  • @danieltomblin9642
    @danieltomblin9642 3 หลายเดือนก่อน

    Thank you for posting from a CRNA student!

  • @christinesullivan5195
    @christinesullivan5195 3 ปีที่แล้ว +1

    This was a great video! I've always been good with my equations, but I never really grasped the complete concept of the A-a gradient and the a/A ratio. You explained this so well and I understand it so much better. Thank you!!

  • @silk.spectre6606
    @silk.spectre6606 3 ปีที่แล้ว +1

    I love this SO MUCH! Thank you! I also had an issue understanding the difference between using A-a gradient vs a-A ratio. I used many different examples, and now I can see how the a-A ratio also helps to understand that when someone overall hypoventilates, they can still transfer 90% of oxygen, which eliminates a diffusion problem, making it a true ventilation problem. Sometimes A-a gradients are abnormal, but the a-A ratios are great. Wow, this video really helped me unravel so much more! I appreciate your help!

  • @jordanlee9607
    @jordanlee9607 3 ปีที่แล้ว +1

    I'm currently at the point of my RT program where it's extremely overwhelming but can I just say how extremely helpful your videos are for a refresher and understanding better?! I can't thank you enough for this content and can't even express how happy I am I found your page!
    Quick question for a reminder: When the a/A ratio is less than 75% what does that indicate?

  • @eman5669
    @eman5669 ปีที่แล้ว +1

    Thank you Coach for wonderful explanation ,

  • @shahadahmed22
    @shahadahmed22 3 ปีที่แล้ว +2

    God bless you, I am an RT and I don’t even need to watch this video but I just love how you teach respiratory and make it clear

    • @RespiratoryCoach
      @RespiratoryCoach  3 ปีที่แล้ว

      Awesome! Thank you so much for watching and kindly commenting!!

  • @acaprig27
    @acaprig27 3 ปีที่แล้ว +1

    Thank you so much for these videos!

    • @RespiratoryCoach
      @RespiratoryCoach  3 ปีที่แล้ว

      You are very welcome! Thank you for watching!

  • @FlightCrit
    @FlightCrit 2 ปีที่แล้ว

    So good!

  • @kimms8610
    @kimms8610 3 ปีที่แล้ว +2

    Hi Coach...great video, clear and helpful as always. 😊

    • @RespiratoryCoach
      @RespiratoryCoach  3 ปีที่แล้ว +1

      Hi Kim!!! Thanks again for watching and commenting!! Glad it made sense.

    • @sumbulkamal9950
      @sumbulkamal9950 3 ปีที่แล้ว

      @@RespiratoryCoach nice vedio thank you

  • @burakozvit7480
    @burakozvit7480 2 หลายเดือนก่อน

    Thank you Sir ❤

  • @zeeshandesai8299
    @zeeshandesai8299 3 ปีที่แล้ว +3

    great teaching!!👏
    a request:
    could you please do a COMPARISON (and expln) on HYBRID/DUAL MODES and their differences (wrt Trigger/Cycle/Limit)... would be of much help

    • @RespiratoryCoach
      @RespiratoryCoach  3 ปีที่แล้ว +1

      Got it on the list! Thanks for watching and requesting!

  • @ahmadal-khouli2723
    @ahmadal-khouli2723 2 ปีที่แล้ว +1

    First of all
    A huge thanks to you for everything you're learning us
    If I may ask
    If I have a covid-19 patient on BiPAP
    7/17 with fio2=100%
    And he's getting better.. Should I make the PEEP lower first? Or the Fio2? And why?
    Thanks in advance

  • @azizbatool1138
    @azizbatool1138 3 ปีที่แล้ว

    can u make video on pressure grandiant

  • @redfox3732
    @redfox3732 2 ปีที่แล้ว

    how to calculate PA02 on a mechanical ventilator? which pressure do we add to the barometric pressure

  • @jellueabigail1706
    @jellueabigail1706 2 ปีที่แล้ว

    What would cause a negative A-a gradient?

  • @jobyjose5526
    @jobyjose5526 3 ปีที่แล้ว +1

    Hi sir How can i adjust PIP on ventilator and what is the normal ranges? Can anyone help me please.

    • @RespiratoryCoach
      @RespiratoryCoach  3 ปีที่แล้ว

      Just replied to your email. Let me know if you have further questions.

  • @lizl.6874
    @lizl.6874 3 ปีที่แล้ว +1

    Hi coach, are the numbers still reliable whether or not some of the alveolis are collapsed, emphysematous or fluid filled where gas exchange is poor? Thanks.

    • @RespiratoryCoach
      @RespiratoryCoach  3 ปีที่แล้ว +1

      Hi Liz. Good to hear from you again. The PAO2 will always be the same depending on what FiO2 is being delivered at what barometric pressure, but the PaO2 will be affected by the scenarios you described. This means that the P(A-a)O2 gradient and a/A ratio will vary with disease processes.

    • @lizl.6874
      @lizl.6874 3 ปีที่แล้ว

      @@RespiratoryCoach always been your supporter! Follow up question: did you mean lower O2 concentration will go into the arterial system by different diseases condition? but the numbers still indicates how much O2 diffused into artery? Thanks

    • @RespiratoryCoach
      @RespiratoryCoach  3 ปีที่แล้ว +2

      @@lizl.6874 It breaks down like this. PAO2 is what we put into the alveoli by increasing or decreasing FiO2. Disease processes have little impact on this number, but a big impact on the amount that actually diffuses into arterial blood for systemic circulation. PaO2 indicates how much diffused into the arteries. The A-a gradient and a/A ratio are indicators of oxygen efficiency. How efficient are the alveoli getting oxygen into arterial circulation. So disease processes will impact PaO2, A-a gradient, and a/A ratio, but have very little impact on PAO2. Hope this helps and so thankful for all the support!!

    • @abdulhikmat6599
      @abdulhikmat6599 3 ปีที่แล้ว +1

      Joe you are really good. You need to teach other people who post Respiratory videos how to teach. Some people are just reading from a script, and some other people have very loud mind scratching harsh music in their videos which literally converts their videos into a wild bar. We don't need any stupid music in these educational videos and we learners need the presenter to explain the concept as you do and have a loud enough voice, and talk close to microphone, not just talking in a hallway.

  • @oshannairby7145
    @oshannairby7145 2 ปีที่แล้ว

    How did u get the PaO2 of 530?

    • @smartguy5592
      @smartguy5592 2 ปีที่แล้ว

      It’s the 80% of 663 and you can get it 663 x 0.80

  • @cherylrajewski3390
    @cherylrajewski3390 2 ปีที่แล้ว +1

    Good video however as a new student I am wondering what PCO2 value you are using. PACO2 or PaCO2 in the equation. I figured it was PACO2.

    • @RespiratoryCoach
      @RespiratoryCoach  2 ปีที่แล้ว

      PaCO2 is divided by RQ to get PACO2. So I start with PaCO2 but end up with PACO2. Make sense?

  • @bertamozo7968
    @bertamozo7968 3 หลายเดือนก่อน

    What would cause a negative A-a gradient?