The Cardiovascular
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A–a oxygen gradient

Alveolar–arterial oxygen difference to characterise hypoxaemia.

A–a oxygen gradient
Age
years
FiO₂
%
PaCO₂
mmHg
PaO₂
mmHg
Complete the fields above to see the result.

When to use

  • Working up hypoxaemia: a normal gradient points to hypoventilation or low FiO₂; a raised gradient points to V/Q mismatch, shunt or a diffusion defect.

Formula

PAO₂ = FiO₂ × (Patm − PH₂O) − PaCO₂ / R = FiO₂ × (760 − 47) − PaCO₂ / 0.8 at sea level. A–a gradient = PAO₂ − PaO₂. Expected ≈ age/4 + 4.

References

  1. Story DA. Alveolar oxygen partial pressure, alveolar carbon dioxide partial pressure, and the alveolar gas equation. Anesthesiology. 1996;84(4):1011.