2020
DOI: 10.36416/1806-3756/e20200505
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Arterial blood gases in the differential diagnosis of hypoxemia

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“…Shunt PHYS (venous admixture; normal ≤ 10%) can be subdivided into: a) anatomic shunt (Shunt ANAT ) via bronchial, pleural, and thebesian veins (normal ≤ 5%); b) capillary shunt (Shunt CAP ), representing pulmonary capillary blood in contact with completely unventilated alveoli; and c) shunt effect (i.e., perfusion in excess of ventilation). 2 Unlike the alveolar-arterial O 2 gradient, 4 Shunt PHYS is independent of the shape of the O 2 dissociation curve, but it requires sampling pulmonary arterial blood to obtain mixed venous oxygen content. Making the subject breathe pure O 2 for sufficient time to wash out nitrogen allows the measurement of the fraction of venous admixture caused by Shunt ANAT plus Shunt CAP (i.e., “absolute shunt”) without the confounding influence of V̇/Q̇ inequalities.…”
Section: Overviewmentioning
confidence: 99%
“…Shunt PHYS (venous admixture; normal ≤ 10%) can be subdivided into: a) anatomic shunt (Shunt ANAT ) via bronchial, pleural, and thebesian veins (normal ≤ 5%); b) capillary shunt (Shunt CAP ), representing pulmonary capillary blood in contact with completely unventilated alveoli; and c) shunt effect (i.e., perfusion in excess of ventilation). 2 Unlike the alveolar-arterial O 2 gradient, 4 Shunt PHYS is independent of the shape of the O 2 dissociation curve, but it requires sampling pulmonary arterial blood to obtain mixed venous oxygen content. Making the subject breathe pure O 2 for sufficient time to wash out nitrogen allows the measurement of the fraction of venous admixture caused by Shunt ANAT plus Shunt CAP (i.e., “absolute shunt”) without the confounding influence of V̇/Q̇ inequalities.…”
Section: Overviewmentioning
confidence: 99%