AaDO2

Data Element (edit)
Field Name:	AaDO2
CCMDB Label:	<not in CCMDB>
CCMDB tab:	Apache
Table:	N/A
Data type:	number
Length:	N/A
Program:	CC
Created/Raw:	Created
Start Date:	1988-07-11
End Date:	2300-01-01
Sort Index:	34

The patient's oxygen level in mmol/L.

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Legacy implementation right in the table

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AaDO2 - Alveolar-arterial oxygen tension difference

• See APACHE Scoring table
• See APACHE FIO2 Table

Measures the difference in the partial pressure of oxygen between the alveoli and the arteries. This measures the efficiency of the oxygen exchange between the lung alveoli and the pulmonary capillaries.

• A calculated component of APACHE II score when FIO2 being administered to a patient is >=50%.

• To calculate the AaDO2:
  • AaDO2 =(( FIO2 X 713) - PaO2) - PaCO2
  • Example with FIO2 50%, PO2 85 and CO2 40:
  • ((0.5 X 713)- 85) - 40)) = 231.5

Apache Physiological Variable
variable name	Alveolar-arterial oxygen tension difference
unit
absolute max allowed
warning max
high score 4	>500
high score 3	>=350 and <500
high score 2	>=200 and <350
high score 1
score 0	<200
low score 1
low score 2
low score 3
low score 4
AP phys warnMin
AP phys absMin

APACHE Score

This value is used to generate the APACHE Score.

Collecting Apache physiological variables

There are some specific rules to follow in choosing which one of several lab results to collect.

See APACHE physiological variable collection for details.

Cross Chcks

Rules described in APACHE_physiological_variable_collection#Exceptionally_high_or_low_values are implemented by Check APACHE physiological variable high low.

Background

Why the constant 713?

The value 713 mmHg is the barometric pressure (Pb) used in the AaDO2 formula.

Normal Sea level Pb is 760 mmHg. (Winnipeg is close to sea level. We don't adjust for different elevations around the city nor do we adjust this value for the constant changes in Pb).

The barometric pressure is corrected for water vapor pressure (Pbc).

• (vapor pressure is 47 mmHg @ a temperature of 37C).
• (760-47)= Pbc of 713 mmHg.

*4 AaDO2 can be 0 or negative

Unlike other physiological variables AaDO2 can be 0 or negative, so onlike the others the score for a 0 AaDO2 is 0 if AaDO2 < 200, which includes AaDO2<=0.

Note for programming only: The score is still null if the AaDO2 is null.

I wonder if "null" is actually intended here, or if it was supposed to be 0. Ttenbergen 14:44, 2017 January 8 (CST) AaDO2 is null if there is no data for FIO2, PaO2 and PaCO2. However, no data was set to zero value instead of null. In addition, AaDO2 and the corresponding score are required only when FIO2 >= 50%, otherwise should be treated as null. (Similarly with PO2 score, it is required when FIO2 < 50% and otherwise should be treated as null. When FIO2 =0, both AaDO2 and its score and PO2 score should be null.) Are we setting null to zero to facilitate the programming calculation? Is it possible to differentiate null from valid zero in both L_LOG and created_variables_CC - will the work be big? In L_LOG, these are the FIO2, CO2, PO2 and SerCO2. 14:49, 2017 March 16 (CDT)

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Data Integrity Checks (automatic list)

	App	Status
Check APACHE physiological variable high low	CCMDB.accdb	implemented