What is Oxygen Deficit?

“The oxygen deficit may present a sensitive indicator of impaired pulmonary gas exchange that could easily be implemented into routine clinical use.”

~ Philipp A. Pickerodt1 and Wolfgang M. Kuebler (2019)

Oxygen Deficit is the difference between end-tidal O2 in lungs (PAO2) and a calculated partial pressure of arterial oxygen (gPaO2TM).  In essence, it reports the degree of inefficiency of the lung to transfer oxygen into the capillary blood. It is obtained non-invasively from a patient’s normal breath at rest.
The Oxygen Deficit is calculated as follows: O2Deficit = PETO2(PAO2) – gPaO2.   The value is calculated by a The MediPines Gas Exchange Monitor (AGM100®) using samples taken during normal breathing and is expressed in mmHg.  Normal patients have single digit to zero values, respiratory patients have a larger gap (e.g., 30 to 50 mmHg, or even higher).
In patients with worsening gas exchange, Oxygen Deficit typically changes more than oxygen saturation. For example, a patient’s arterial oxygen saturation (SpO2) may fall by only 2% or 3% but their Oxygen Deficit tends to increase by a much wider margin (e.g., 10 mm Hg) than SpO2, providing a more sensitive indicator of gas exchange impairment. This wider margin allows for medical professionals to recognize deteriorating conditions and response to therapy more readily.
The concept of determining the Oxygen Deficit using a non-invasive method was pioneered by John B. West, a globally known physiologist (medical text book author of Respiratory Physiology The Essentials), and a team of respiratory physicians at UC San Diego School of Medical School.
 
Data, as shown, is based on a clinical study conducted and published in 2017/2018, normal subject data were captured under hypoxic conditions.

Normal Subjects vs. Respiratory Patients (COPD)

Representative Individual Data

Representative Clinical Findings

A New, Noninvasive Method of Measuring Impaired Pulmonary Gas Exchange in Lung Disease: An Outpatient Study. J.B., Crouch D.R., Fine J.M., Makadia D., Wang D.L., Prisk G.K.CHEST.2018;154(2), pp. 363-369.
https://www.ncbi.nlm.nih.gov/pubmed/29452100

Measurements of pulmonary gas exchange efficiency using expired gas and oximetry: results in normal subjects., J.B., Wang, DL., Prisk DK.American Journal of Physiology-Lung Cellular Molecular Physiology.2018 Apr 1;314(4): L686-L689.
https://www.ncbi.nlm.nih.gov/pubmed/29351442

Noninvasive measurement of pulmonary gas exchange: comparison with data from arterial blood gases. , J. B., Wang, D. L., Prisk, G. K., Fine, J. M., Bellinghausen, A., Light, M. P., & Crouch, D. R.American Journal of Physiology-Lung Cellular and Molecular Physiology. 2018.
https://www.ncbi.nlm.nih.gov/pubmed/30335497