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V/Q Mismatch Physiology

by Dr. Lizzy Hastie @LizzyHastie

#VQMismatch #pathophysiology #diagnosis #pulmonary
V/Q Mismatch Physiology ... LizzyHastie #VQMismatch
Hypoxemia Differential Diagnosis Algorithm by A-a Gradient

Normal A-a Gradient:
 • ↓ Atmospheric pressure
 • Hypoventilation: CNS
Algorithm by A-a Gradient ... Normal A-a Gradient ... compliance ↑ A-a Gradient ... Alveolar • V/Q Mismatch ... pulmonary #Aa #Gradient
Approach to the A-a Gradient
A-a gradient = PAO2 - PaO2
A-a gradient = [FiO2 x (Patm -
Approach to the A-a Gradient ... A-a gradient = ... PAO2 - PaO2 A-a gradient ... A-a Gradient ≤ ... and more • V/Q Mismatch
Severity of Aortic Stenosis in Adults 
Current ACC/AHA guidelines recommend cut-off values for Doppler-echocardiographic measurements of
0.6 cm2/m2, mean gradient ... transvalvular gradient ... , inconsistent grading ... common problem in clinical ... <1 cm2 with a gradient
Aortic Stenosis Grading on echocardiography
The cut-offs for grading can be found in table 1. Discrepancies are
Aortic Stenosis Grading ... The cut-offs for grading ... 4.0 m/s and mean gradient
Commonly Used Clinical Grading Systems
 • Edema Grading Scale
 • Hepatic Encephalopathy Grading (West Haven Criteria)
Commonly Used Clinical ... Grading Systems ... • Edema Grading ... Encephalopathy Grading ... • Ascites Grading
Ascites Differential Diagnosis Table - Serum Ascites Albumin Gradient (SAAG)

SAAG ≥ 1.1:
 • Cirrhosis
 • Portal
Ascites Albumin Gradient ... Serum #Albumin #Gradient
GRADING in clinical medicine

Grading system is often used in Clinical medicine to indicate the severity scale
GRADING in clinical ... medicine Grading ... often used in Clinical ... are some of the grading ... know any other grading
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG)
SAAG ≥ 1.1:
 - Ascitic protein
ascites albumin gradient ... ascites #albumin #gradient
Hypoxemic Respiratory Failure - Differential Diagnosis Framework
DECREASED INSPIRED OXYGEN
 • Low PATM Can decrease first part
common than VIQ mismatch ... PERFUSION (V/Q) MISMATCH ... gravity-dependent gradients