The impact of ventilation–perfusion inequality in COVID-19: a computational model-Reference-Cited by-同舟云学术

The impact of ventilation–perfusion inequality in COVID-19: a computational model

Published:2021-03-01 Issue:3 Volume:130 Page:865-876
ISSN:8750-7587
Container-title:Journal of Applied Physiology
language:en
Short-container-title:Journal of Applied Physiology

Author:

Busana Mattia¹^ORCID,Giosa Lorenzo²,Cressoni Massimo³,Gasperetti Alessio⁴,Di Girolamo Luca⁵,Martinelli Alessandra⁶,Sonzogni Aurelio⁷,Lorini Luca⁶,Palumbo Maria Michela¹,Romitti Federica¹,Gattarello Simone¹,Steinberg Irene¹,Herrmann Peter¹,Meissner Konrad¹,Quintel Michael¹,Gattinoni Luciano¹^ORCID

Affiliation:

1. Department of Anesthesiology, Intensive Care and Emergency Medicine, University Medical Center of Göttingen, Göttingen, Germany

2. Department of Surgical Science, University of Turin, Italy

3. Unit of Radiology, IRCCS Policlinico San Donato, San Donato, Italy

4. Department of Cardiology, IRCCS Cardiologico Monzino, San Donato Milanese, Italy

5. Department of Intensive Care Medicine, IRCCS Policlinico San Donato, San Donato Milanese, Italy

6. ASST Papa Giovanni XXIII, Department of Intensive Care Medicine, Bergamo, Italy

7. ASST Papa Giovanni XXIII, Department of Pathology, Bergamo, Italy

Abstract

Hypothesizing that the non-aerated lung fraction as evaluated by the quantitative analysis of the lung computed tomography (CT) equals shunt (VA/Q = 0), we used a computational approach to estimate the magnitude of the ventilation–perfusion mismatch in severe COVID-19. The results show that a severe hyperperfusion of poorly ventilated lung region is likely the cause of the hypoxemia observed. The extensive microthrombosis of the pulmonary circulation may represent the pathophysiological mechanism of such VA/Q distribution.

Publisher

American Physiological Society

Subject

Physiology (medical),Physiology

Link

https://journals.physiology.org/doi/pdf/10.1152/japplphysiol.00871.2020

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