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A pulmonary shunt is the passage of deoxygenated blood from the right side of the heart to the left without participation in gas exchange in the pulmonary capillaries. It is a pathological condition that results when the alveoli of parts of the lungs are perfused with blood as normal, but ventilation (the supply of air) fails to supply the perfused region.
The Shunt equation (also known as the Berggren equation) quantifies the extent to which venous blood bypasses oxygenation in the capillaries of the lung.. “Shunt” and “dead space“ are terms used to describe conditions where either blood flow or ventilation do not interact with each other in the lung, as they should for efficient gas exchange to take place.
Ventilation–perfusion coupling is the relationship between ventilation and perfusion processes, which take place in the respiratory system and the cardiovascular system. [1] Ventilation is the movement of gas during breathing, and perfusion is the process of pulmonary blood circulation , which delivers oxygen to body tissues. [ 2 ]
In cardiology, a cardiac shunt is a pattern of blood flow in the heart that deviates from the normal circuit of the circulatory system. It may be described as right-left , left-right or bidirectional, or as systemic-to-pulmonary or pulmonary-to-systemic .
Physiologic dead space cannot change as it is ventilation without perfusion. A shunt is a perfusion without ventilation within a lung region. [citation needed] Low tidal volume ventilation was the primary independent variable associated with reduced mortality in the NIH-sponsored ARDSNet trial of tidal volume in ARDS.
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
Therefore it includes, firstly those units that are ventilated but not perfused, and secondly those units which have a ventilation-perfusion ratio greater than one. Alveolar dead space is negligible in healthy individuals, but it can increase dramatically in some lung diseases due to ventilation-perfusion mismatch.
A Peritoneovenous shunt: (also called Denver shunt) [2] is a shunt which drains peritoneal fluid from the peritoneum into veins, usually the internal jugular vein or the superior vena cava. It is sometimes used in patients with refractory ascites. It is a long tube with a non-return valve running subcutaneously from the peritoneum to the ...
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