Gas-exchange in mechanically ventilated patients

Part of the Topics in Anaesthesia and Critical Care book series (TIACC)


Adequate management of patients with respiratory failure requires proper assessment of pulmonary gas exchange. Partial pressures of arterial blood gases (PaO2 and PaCO2) and pH are the directly measurable variables used by most clinicians for this purpose. Although arterial blood gases have become increasingly easy to obtain in both intensive care and medical care settings, often the interpretation of the pathophysiologic determinants of abnormal PaO2 and/or PaCO2 in the clinical arena is not straightforward. This is because arterial blood gases reflect not only the functional conditions of the lung as a gas exchanger, thereby their intrapulmonary determinants (i.e. ventilation-perfusion heterogeneities, intrapulmonary shunt and alveolar to end-capillary diffusion limitation for oxygen), but also the conditions under which the lung operates, namely the composition of inspired gas and mixed venous blood (i.e. extrapulmonary factors) [1–6].


Acute Respiratory Distress Syndrome Acute Respiratory Distress Syndrome Patient Noninvasive Positive Pressure Ventilation Control Mechanical Ventilation Intrapulmonary Shunt 
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© Springer-Verlag Italia, Milano 1999

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  • J. Roca

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