Why do vasodilators administered via the intravenous route cause an increase in intrapulmonary shunting and a decreased Pao2?
A. because they come in contact with all the vessels of both systemic and pulmonary vasculatures
B. because they often cause pooling of venous blood in the systemic venous circulation
C. because they dilate vessels of both ventilated and unventilated alveoli in the pulmonary vasculature
D. because they cause a decreased cardiac output as an untoward effect
ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: In contrast to inhaled NO (iNO), intravenous vasodilators (e.g., sodium nitroprusside and nitroglycerin) are not selective vasodilators. Although intravenous vasodilators lower pulmonary artery pressure, they also lower systemic blood pressure. Moreover, these agents increase blood flow to both ventilated and unventilated alveoli, resulting in increased intrapulmonary shunting and a lower Pao2.
D. Incorrect response: See explanation C.
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