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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]
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]
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 ...
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
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.
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.
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.