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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 respiratory physiology, the ventilation/perfusion ratio (V/Q ratio) is a ratio used to assess the efficiency and adequacy of the ventilation-perfusion coupling and thus the matching of two variables: V – ventilation – the air that reaches the alveoli; Q – perfusion – the blood that reaches the alveoli via the capillaries
The ventilation/perfusion ratio (V/Q ratio) is higher in zone #1 (the apex of lung) when a person is standing than it is in zone #3 (the base of lung) because perfusion is nearly absent. However, ventilation and perfusion are highest in base of the lung, resulting in a comparatively lower V/Q ratio.
The control of ventilation is the physiological mechanisms involved in the control of breathing, which is the movement of air into and out of the lungs. Ventilation facilitates respiration. Respiration refers to the utilization of oxygen and balancing of carbon dioxide by the body as a whole, or by individual cells in cellular respiration. [1]
By redirecting blood flow from poorly-ventilated lung regions to well-ventilated lung regions, HPV is thought to be the primary mechanism underlying ventilation/perfusion matching. [1] [2] The process might initially seem counterintuitive, as low oxygen levels might theoretically stimulate increased blood flow to the lungs to increase gas exchange.
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.
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Next, the lung is connected to the EVLP circuit and ventilator. Perfusion is initiated at a low flow rate, gradually increasing to the target flow of 40%. Meanwhile, the perfusate temperature is raised to normothermia. Ventilation begins once the perfusate reaches 37˚C, with some adjustments made to ensure adequate circulation and ventilation.