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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.
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.
Ideally, the oxygen provided via ventilation would be just enough to saturate the blood fully. In the typical adult, 1 litre of blood can hold about 200 mL of oxygen; 1 litre of dry air has about 210 mL of oxygen. Therefore, under these conditions, the ideal ventilation perfusion ratio would be about 0.95.
This equation is the foundation for the MIGET, and it demonstrates that the fraction of inert gas not eliminated from the blood via the lung is a function of the partition coefficient and the V A /Q ratio. This equation operates under the presumption that the lung is perfectly homogenous.
The right-to-left shunt is an abnormal blood circulation that enables deoxygenated blood to pass from the right side to the left side of the heart and skips the lungs. Thus, no oxygenation occurs, and reduced gas exchange results in hypoxemia as fresh oxygen cannot reach the shunted blood. [18]
Differentiation between a right-to-left shunt and pulmonary disease is often aided clinically by the results of a hyperoxia test. [citation needed] Using high levels of inspired oxygen should have little effect on the dissolved O2 in the blood because highly oxygenated blood is diluted by shunted (low oxygenation) blood.
For example, in high altitude, the arterial oxygen PaO 2 is low but only because the alveolar oxygen (PAO 2) is also low. However, in states of ventilation perfusion mismatch, such as pulmonary embolism or right-to-left shunt, oxygen is not effectively transferred from the alveoli to the blood which results in an elevated A-a gradient.
Evaluation can be done during a cardiac catheterization with a "shunt run" by taking blood samples from superior vena cava (SVC), inferior vena cava (IVC), right atrium, right ventricle, pulmonary artery, and system arterial. Abrupt increases in oxygen saturation support a left-to-right shunt and lower than normal systemic arterial oxygen ...