A patient breathing 40% O2 at sea level has a PaO2 of 50 mm Hg, a PCO2 of 30 mm Hg, and a PAO2 – PaO2 of 250 mm Hg. When the FiO2 is raised to 0.7, the PaO2 rises to only 58 mm Hg. Hypoxemia is primarily due to which of the following?
a. Hypoventilation
b. Impaired diffusion
c. Right-to-left shunt
d. imbalance
ANS: C
A of 0 represents a special type of imbalance. When the is 0, there is blood flow but no ven-tilation. The result is equivalent to a right-to-left anatomical shunt, shown at the bottom of Figure 12-15. Venous blood bypasses ventilated alveoli and mixes with freshly oxygenated arterial blood, resulting in what is called a venous admixture. Right-to-left physiologic shunting results in a more severe form of hypoxemia than does a simple .
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