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KMID : 0604019960110010021
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Korean Journal of Critical Care Medicine
1996 Volume.11 No. 1 p.21 ~ p.26
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Intrapulmonary Shunting and Hypoxemia
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Kim Dong-Soo
Shin Ok-Young
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Abstract
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Intracellular utilization of oxygen is essential to all metabolic functions; preventing tissue hypoxia is a primary goal of oxygen therapy. It has generally been known that hypoxemia is usually due to alveolar hypoventilation, ventilation-perfusion mismatching, shunting and all arterial hypoxemia is either due to a decreased alveolar oxygen tension (shunt effect) or true intrapulmonary shunting. Shunt effect has little clinical significance if the alveolar partial pressure of oxygen are great enough to saturate the exposed hemoglobin fully. While hypoxemia due to shunt effect is relatively well responsive to oxygen therapy, hypoxemia due to true shunting is not nearly so responsive to increased inspired oxygen concentrations. So the primary goal of treatment of patients with hypoxemia due to true shunting should include chest physiotherapy, CPAP, PEEP as well as adjustment of inspired oxygen concentrations.
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KEYWORD
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Hypoxemia, Shunt, Oxygen therapy,
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