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Extrapulmonary and Intrapulmonary Determinants of Pulmonary Gas Exchange

  • Conference paper
Ventilatory Failure

Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 15))

Abstract

In order to best manage patients with respiratory failure in both the intensive and the medical care setting, proper assessment of pulmonary gas exchange is crucial. Arterial blood respiratory gases (O2 and CO2) and acid-base status are the directly measurable variables used by most clinicians for this purpose. However, while respiratory gases have become increasingly easy to obtain in recent years, their interpretation has become also progressively more difficult, especially in the intensive care setting. This is because of deepening awareness that factors other than intrapulmonary abnormalities can alter arterial PO2 and PCO2. Ideally, it would be of great practical interest to clinicians to handle respiratory blood gas measurements as an index of the state of the lungs, such that improved or impaired results could be equated to improve or impair lung function, respectively. The situation is that arterial PO2 and PCO2 reflect not only the state of the lung, at least as a gas exchanger, and thereby their intrapulmonary determinants (i.e. ventilation-perfusion \({\mathop {\text{V}}\limits^. _{\text{A}}}/\mathop {\text{Q}}\limits^. \) mismatch, intrapulmonary shunt and alveolar-end-capillary diffusion limitation for oxygen) but also the conditions under which the lung is operating, namely the composition of inspired gas and mixed venous blood, i.e. their extrapulmonary factors.

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Authors
  1. R. Rodriguez-Roisin
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  2. J. Roca
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  3. J. A. Barbera
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Editor information

Editors and Affiliations

  1. St. Paul-Ramsey Medical Center, 640 Jackson Street, St. Paul, MN, 55101-2595, USA

    J. J. Marini

  2. Department of Critical Care, Evangelismos Hospital, 45, Ipsilandou Street, Athens, 11521, Greece

    C. Roussos

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© 1991 Springer-Verlag Berlin Heidelberg

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Rodriguez-Roisin, R., Roca, J., Barbera, J.A. (1991). Extrapulmonary and Intrapulmonary Determinants of Pulmonary Gas Exchange. In: Marini, J.J., Roussos, C. (eds) Ventilatory Failure. Update in Intensive Care and Emergency Medicine, vol 15. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84554-3_2

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  • DOI: https://doi.org/10.1007/978-3-642-84554-3_2

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-84556-7

  • Online ISBN: 978-3-642-84554-3

  • eBook Packages: Springer Book Archive

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