somthing clinical for a change:
I have recently read about the phenomena that exsits where patients in a (lateral recumbent position) for example will have a v/q mismatch. I qualify this with the explination that due to gravity , perfussion will prefer the dependant lung while ventilation would prefer the independant lung do to the increased tone of muscles of expiration which causes greater recoil of the lung thus increasing the compliance of the independant alveoli compared to that of the dependant lung alveoli.
now. what if I had to drop a lung? then what. what if i have an open chest which would only amplify the mismatch do the the increased distensbility of the independant lung. I am in awe as to how anesthesia providers blance these physiologic problems. I am sure we'll learn more down the road but due to my impatients I want an answer. how do you deal with a mismatch like this. what if one lung is sick.. yeesh... it just gets more and more complicated.