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Calcimator

A-a Gradient Calculator

Calculate the alveolar-arterial (A-a) oxygen gradient to evaluate oxygenation and differentiate causes of hypoxemia.

Inputs

%
mmHg

Normal PaO₂: 80–100 mmHg (room air); mild hypoxemia 60–79; moderate 40–59; severe <40 mmHg

mmHg

Normal PaCO₂: 35–45 mmHg; <35 resp. alkalosis; >45 resp. acidosis; used in alveolar gas equation

mmHg
years

Results

A-a Gradient

4.7mmHg

Elevated

0(0=No, 1=Yes)

Expected Gradient (for Age)14mmHg
Alveolar PO₂ (PAO₂)99.7mmHg
a/A Ratio0.95
How to Use This Calculator
  1. Enter FiO₂, PaO₂, PaCO₂, atmospheric pressure, and patient age.
  2. Review the A-a gradient — normal is < age/4 + 4 mmHg on room air.
  3. An elevated A-a gradient suggests a parenchymal, vascular, or diffusion lung abnormality.

How the result changes with Atmospheric Pressure

Atmospheric PressureA-a GradientElevated
440-62.5mmHg0(0=No, 1=Yes)
540-41.5mmHg0(0=No, 1=Yes)
660-16.3mmHg0(0=No, 1=Yes)
7604.7mmHg0(0=No, 1=Yes)

What each input means

FiO₂
Fraction of inspired oxygen as a percentage. Room air = 21%.
PaO₂
Arterial partial pressure of oxygen from arterial blood gas (ABG). Normal range: 80–100 mmHg on room air (age-adjusted: ≈104 − 0.27×age mmHg). Mild hypoxemia: 60–79 mmHg; moderate: 40–59; severe: <40 mmHg.
PaCO₂
Arterial partial pressure of carbon dioxide from ABG. Normal range: 35–45 mmHg. Respiratory alkalosis: <35 mmHg (hyperventilation); respiratory acidosis: >45 mmHg (hypoventilation). Used in alveolar gas equation: PAO₂ = FiO₂×(Patm−47) − PaCO₂/0.8.
Atmospheric Pressure
Barometric pressure. Sea level = 760 mmHg. Adjust for altitude.
Patient Age
Patient age for calculating expected A-a gradient.

How this is calculated

Worked example, using the default values

  1. Identify Input Parameters
    4 parameters
    FiO₂ = 21, PaO₂ = 95, PaCO₂ = 40, Atmospheric Pressure = 760 = 5 input(s) provided
  2. Calculate A-a Gradient
    A-a Gradient
    4.7 = 4.7
  3. Calculate Elevated
    Elevated
    0 = 0
  4. Calculate Expected Gradient
    Expected Gradient
    14 = 14
  5. Calculate Alveolar PO₂
    Alveolar PO₂
    99.7 = 99.7

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