A-a Gradient Calculator

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The A-a Gradient Calculator is a tool used in respiratory medicine to assess the efficiency of gas exchange in the lungs. The A-a Gradient represents the difference between the partial pressure of oxygen in the alveoli (A) and the partial pressure of oxygen in arterial blood (a).

A-a Gradient Calculator

Basic
Advanced

The A-a Gradient Calculator is divided into two versions: Basic and Advanced.

Basic Version:

  • FiO₂: Fraction of inspired oxygen
  • PaO₂ (mmHg): Alveolar Partial Pressure of Oxygen
  • PaCO₂ (mmHg): Arterial partial pressure of carbon dioxide

Advanced Version:

  • FiO₂: Fraction of inspired oxygen
  • PaO₂ (mmHg): Alveolar Partial Pressure of Oxygen
  • PaCO₂ (mmHg): Arterial partial pressure of carbon dioxide
  • Patm: Atmospheric Pressure (mmHg):
  • PH₂O: water vapor pressure

A-a Gradient Formula

A−aGradient = (FiO2​×(Patm−Ph2​O)) – (PaCO2 / R) – PaO2

Standard Value:

  • Patm = 760 mmHg (standard atmospheric pressure)
  • Ph₂O = 47 mmHg (partial pressure of water vapor at body temperature)
  • R = 0.8 (Respiratory quotient)

For example:

  • FiO₂ (Fraction of Inspired Oxygen): 0.10
  • PaO₂ (Partial Pressure of Oxygen in Arterial Blood, mmHg): 10
  • PaCO₂ (Partial Pressure of Carbon Dioxide in Arterial Blood, mmHg): 10

First, we need to calculate the Alveolar Oxygen (A):

A = FiO2​ × (Patm−Ph2​O)

A = 0.10×(760−47)=0.10×713 = 71.3mmHg

Second, we need to calculate the Correction for CO₂ (B):

B = R/PaCO2​​ = 0.8/10​ = 12.5mmHg

In the third step, you can calculate the A-a Gradient:

A−a Gradient = A − B − PaO2​

A−a Gradient = 71.3−12.5−10 = 48.8mmHg

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