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Any deviation from this value is considered a V/Q mismatch. Maintenance of the V/Q ratio is crucial for preservation of effective pulmonary gas exchange and maintenance of oxygenation levels. A mismatch can contribute to hypoxemia and often signifies the presence or worsening of an underlying pulmonary condition. [3]
The V/Q ratio can be measured with a two-part ventilation/perfusion scan (V/Q scan). [1] Using a small amount of inhaled or injected radioactive material called a tracer for visualization, a V/Q scan is a type of nuclear medical imaging that allows for localization and characterization of blood flow ( perfusion scan ) and measurement of airflow ...
A pulmonary ventilation-perfusion scan (lung V/Q scan) can be used to diagnose the V/Q mismatch. A ventilation scan is used to measure airflow spread and a perfusion scan for blood flow distribution in the lungs. A radioactive tracer is used to scan the whole lung and the ventilation and perfusion function. [21]
Hypoxemia is caused by five categories of etiologies: hypoventilation, ventilation/perfusion mismatch, right-to-left shunt, diffusion impairment, and low PO 2. Low PO 2 and hypoventilation are associated with a normal alveolar–arterial gradient (A-a gradient) whereas the other categories are associated with an increased A-a gradient. [11]: 229
Ventilation perfusion mismatch (V/Q mismatch), which can be either low or high. [8] A reduced V/Q ratio can be caused by impaired ventilation, which may be a consequence of conditions such as bronchitis, obstructive airway disease, mucus plugs, or pulmonary edema, which limit or obstruct the ventilation.
A ventilation/perfusion lung scan, also called a V/Q lung scan, or ventilation/perfusion scintigraphy, is a type of medical imaging using scintigraphy and medical isotopes to evaluate the circulation of air and blood within a patient's lungs, [1] [2] in order to determine the ventilation/perfusion ratio.
An abnormally increased A–a gradient suggests a defect in diffusion, V/Q mismatch, or right-to-left shunt. [5] The A-a gradient has clinical utility in patients with hypoxemia of undetermined etiology. The A-a gradient can be broken down categorically as either elevated or normal. Causes of hypoxemia will fall into either category.
As the mismatch between ventilation and perfusion grows, blood oxygen saturation is reduced. [41] Pulmonary hypoxic vasoconstriction, in which blood vessels near the hypoxic alveoli constrict (narrow their diameter) in response to the lowered oxygen levels, can occur in pulmonary contusion. [ 27 ]