Novel gas exchange analysis in COVID-19 lung disease. Issue 1 (26th January 2023)

• Record Type: Journal Article
• Authors: Hughes, Mike
• Is Part Of: European respiratory journal. Volume 61:Issue 1(2023)
• Publication Date: 2023-01-26
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.01962-2022
• Languages: English
• ISSNs: 0903-1936

Abstract

The study by Harbut et al. [1] reported in this issue of the European Respiratory Journal analyses gas exchange in patients with acute coronavirus disease 2019 (COVID-19) lung disease; arterial oxygen and carbon dioxide tension ( P O2 and P CO2 ) and the mean (or mixed) value for alveolar (A̅) P O2 and P CO2 (not an "ideal" [2] but the actual value) were measured, when patients (and healthy controls) were breathing air. From the mean alveolar to arterial P O2 and arterial to mean alveolar P CO2 gradients (A̅a P O2 and aA̅ P CO2 ), the authors computed intrapulmonary shunt and alveolar dead space using the classical three compartment model of Riley and Cournand [2] (but, with important differences: see later). Harbut et al. [1] argued that intrapulmonary shunt should be a marker for alveolar consolidation, as in lobar pneumonia, but at a more microscopic level; alveolar dead space, on the other hand, should be a surrogate for pulmonary microvascular obstruction and thrombosis, e.g. following severe endothelial injury. A new method of measuring mean alveolar P O2 and P CO2 (as opposed to the classical ideal alveolar air analysis) with arterial P O2 and P CO2, is applied to patients with COVID-19 lung disease, acutely and after recovery https://bit.ly/3Tuaffb