Hello. Thank you for the excellent video and youtube channel doctor. I have 2 questions: 1- I understand V/Q mismatch is physiological and we normally have because of the difference between the apex and the base of the lung, then why don´t we all have hypoxemia? 2- Wouldn´t pneumonia cause hypoxemia through shunt mecanism due to the exudate inside the alveoli? Thanks again! and much respect.
2 - pneumonia doesn't affect every single alveoli the same - there may still be some functional and normal ones in the sick bunch that can still ventilate the capillaries, so it's not a true shunt.
Hi, I have a doubt, you just explained that the upper areas of the lungs have a higher V/Q ratio compared to the lower areas. Is that the case when there in no pathology at all and everything is okay in the system? Or is it only the case when if the lungs are diseased?
Question: in the pulmonary embolism example, are you saying that the blocked portion of lung is high VQ? Or dead space? So in that case giving 100% oxygen would be helpful because the hyper-perfused alveoli would be able to keep up with the flow of rbcs? I’m Trying to understand it better.
I have a question: you said all V/Q mismatch besides shunting responds to O2, But I've heard from other lectures that only high (V/Q>1) mismatch responds to O2 and low (V/Q
so i this why a lot of septic patients are SOB? the distributive shock dilates the vasculature causing a V/Q mismatch? And that giving a pressor could potentially relieve the SOB (understanding o2 application would be the better/easiest/basic option first)
septic patients are a little more complicated because spetic patients produce more CO2, they are hypoxemic AND hypoxic! so their core issue is deeper than V/Q mismatch because their V/Q mismatch stems from hypercapnia
So is the reason there is low ventilation in the base is because there is more blood flow with allows less time for ventilation to occur before the blood is moved out of the capillary for shunting?
So this is probably a dumb question, but I can’t figure it out. You said that v/q ratios are higher in the apex than the bases, and that v/q mismatch occurs because of the juxtaposition between high v/q in one part of the lung and a low v/q in another. My question is, why isn’t a v/q mismatch standard? If the apex is high and the bases are low.... if an obstruction in the apex, say emphysema caused the apex v/q to lower, wouldn’t it now match the bases more closely and therefore not have a mismatch anymore?
7:47 for example in hypoxemic patient with pneumonia you can't say the patient has low v/q mismatch the accurate way to describe it is by saying the patient have low v/q ratio ?
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Arguably the best explained video on a complex topic like V/Q!
Freakin legend, me and everyone else can't thank you enough.
Much love
Thank you!
wayyy better than my school can do. They should just assign us your videos to watch
Do you just want to take my med school tuition at this point?
amazing job. now I'm able to understand this subject more clearly
SO MUCH BETTER THAN ANOTHER VIDEO I WATCH AND WAS COMPLETELY LOST!
You helped me pass my CCRN! Thank you!!!
Happy to help!
Good video. Thanks!
You are a true blessing! Thank you for such an incredible explaination!
Thank you for so clearly explaining this!!!
thank you for explaining so good
Very clear explanation! Thank you :)
I cant thank you enough
Absolutely appreciated
Thank you.
thx again and again! phenomenal
Hello. Thank you for the excellent video and youtube channel doctor. I have 2 questions:
1- I understand V/Q mismatch is physiological and we normally have because of the difference between the apex and the base of the lung, then why don´t we all have hypoxemia?
2- Wouldn´t pneumonia cause hypoxemia through shunt mecanism due to the exudate inside the alveoli?
Thanks again! and much respect.
I have the same question.
I have the same 2 questions
2 - pneumonia doesn't affect every single alveoli the same - there may still be some functional and normal ones in the sick bunch that can still ventilate the capillaries, so it's not a true shunt.
thank u so much ! we love u !!!!
Good explanation (y)
Hmm.. now I know what v/q is but still don't know what mismatch is.
Death space and shunting are extreme V/Q mismatch or pathological shunts or even both?
Hi, I have a doubt, you just explained that the upper areas of the lungs have a higher V/Q ratio compared to the lower areas. Is that the case when there in no pathology at all and everything is okay in the system? Or is it only the case when if the lungs are diseased?
Occurs normally.
Would remodulin help with this?
how did you do it can you share with me , thank you
thank you! my teacher clearly does not understand this!
Question: in the pulmonary embolism example, are you saying that the blocked portion of lung is high VQ? Or dead space?
So in that case giving 100% oxygen would be helpful because the hyper-perfused alveoli would be able to keep up with the flow of rbcs? I’m Trying to understand it better.
I have a question: you said all V/Q mismatch besides shunting responds to O2, But I've heard from other lectures that only high (V/Q>1) mismatch responds to O2 and low (V/Q
Mismatch is when you have both. I.e. they are not matched.
👍
so i this why a lot of septic patients are SOB? the distributive shock dilates the vasculature causing a V/Q mismatch? And that giving a pressor could potentially relieve the SOB (understanding o2 application would be the better/easiest/basic option first)
septic patients are a little more complicated because spetic patients produce more CO2, they are hypoxemic AND hypoxic! so their core issue is deeper than V/Q mismatch because their V/Q mismatch stems from hypercapnia
I still don’t know why med school can’t hire people like this to teach.. Professors makes your life horrible
You say that a 100% oxygen would make a difference, but what difference?
maybe it's because a 100% oxygen will make the blood 95%+ saturated which mean it's > 90 % so the blood not in the hypoxic state. (cmiiw)
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So is the reason there is low ventilation in the base is because there is more blood flow with allows less time for ventilation to occur before the blood is moved out of the capillary for shunting?
So this is probably a dumb question, but I can’t figure it out. You said that v/q ratios are higher in the apex than the bases, and that v/q mismatch occurs because of the juxtaposition between high v/q in one part of the lung and a low v/q in another. My question is, why isn’t a v/q mismatch standard? If the apex is high and the bases are low.... if an obstruction in the apex, say emphysema caused the apex v/q to lower, wouldn’t it now match the bases more closely and therefore not have a mismatch anymore?
Thank you sir , you're a legend 🌼
Excellent video thank you.
You're amazing! Thank you for this.
This video is helping so many generations of med students. Thank you sir!
7:47 for example in hypoxemic patient with pneumonia you can't say the patient has low v/q mismatch the accurate way to describe it is by saying the patient have low v/q ratio ?
@medcram can't drowning cause V/Q mismatch?
You just saved me
Thank you so much!!!
Made it so easyyy!!!
👍👍👍👍
Seems easy