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Yearbook of Intensive Care and Emergency Medicine pp 420–433Cite as

Methods to improve Matching between Ventilation and Perfusion during Ventilatory Support in ARDS

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Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 1996))

Abstract

Acute respiratory distress syndrome (ARDS) causes alveolar collapse primarily in dependent lung areas with decrease in resting lung volume and lung compliance, resulting in a mismatch between ventilation and perfusion \(\left( {{{\dot V}_A}/\dot Q} \right)\) [1, 2]. The \({\dot V_A}/\dot Q\) mismatch accounts entirely for the arterial hypoxemia observed during ARDS [2]. Application of positive airway pressure is commonly used to increase lung volume and recruit initially poorly- or non-ventilated lung units, improving ventilation distribution to well-perfused lung areas [31. Recent development in the treatment of ARDS have introduced techniques such as inhalation of nitric oxide (NO) [4] or prostaglandins [5] that cause vasodilation selectively in ventilated lung units and improve redistribution of blood flow from non-ventilated to ventilated lung units and pulmonary oxygen transfer. The following discussion will attempt to clarify the principles of different techniques used to optimize ventilatory support, and their expected and observed effects on \({\dot V_A}/\dot Q\) matching.

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  1. C. Putensen
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Editors and Affiliations

  1. Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Clinical Director) (Clinical Director)

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© 1996 Springer-Verlag Berlin Heidelberg

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Putensen, C. (1996). Methods to improve Matching between Ventilation and Perfusion during Ventilatory Support in ARDS. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine. Yearbook of Intensive Care and Emergency Medicine, vol 1996. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-80053-5_37

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  • DOI: https://doi.org/10.1007/978-3-642-80053-5_37

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-60552-2

  • Online ISBN: 978-3-642-80053-5

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