Alveolar-Arterial Oxygen Gradient (A-a Gradient)


The difference between the amount of oxygen in the alveoli (PAO2 or Alveolar oxygen tension) and the amount of oxygen dissolved in the plasma (PaO2)

Describes the efficiency of O2 uptake from alveoli to pulmonary capillary blood

Formula:


A-a oxygen gradient = PAO2 - PaO2
PAO2 = alveolar gas equation
PAO2 = (FiO2 [Patm - PH2O]) - (PaCO2 / R)
PAO2 = (0.21 [760-47]) -  (PaCO2 / 0.8)
Where:
 

Results:

Can help differentiate cause of hypoxemia as being extrapulmonary (e.g. hypoventilation) vs intrapulmonary (intrinsic lung disease)

Normal: <20 mmHg

Widened >20 mmHg (suggestive of underlying lung disease)