Oxygenation vs Ventilation

[ARobertson79]

First of all, thanks for taking the time to read this :)

I have a question about oxygenation vs ventilation. My question is what diseases fall under each of this conditions. I understand you must ventilate to push air in and out of the lungs. Oxygenation is, well, oxygen.

So would COPD and a PE be considered a oxygenation problem. Asthma and Sleep apnea be considered ventilation?

Any more examples with explanations would be awesome. Thanks guys!

Amy

Junior I

[Intern67]

I'm not sure it is beneficial to try to separate diseases into those two categories.

Oxygenation refers to O2 being delivered to tissues in sufficient quantities. It is not a process that happens only in the lungs.

[TRR8021]

Yeah, I've never heard of separating the diseases like that. Do you mean respiration vs. ventilation? That's how I learned it. When you say oxygenation I think of supplemental oxygen therapy.

[njmomstudent]

I know my daughters small spontaneous pneumothorax at birth was treated with just oxygen... that may be another scenario for you to include.

[RNTutor, BSN, RN]

Yeah, I've never heard of separating disease that way. Now if you wanted to talk about which diseases typically warrant oxygen therapy versus which disease typically require a ventilator...I could wrap my brain around that a little better.

[FlyingScot, RN]

I thought it was a strange viewpoint at first until I thought about it a bit. If you look at it from the standpoint of simple ABGs it kind of makes sense. A person with a ventilation problem will have high pCO2s. A person with an oxygenation problem will have low pO2s. Have you ever heard a patient described as " he/she is oxygenating but not ventilating" or vice versa? Now think about different respiratory conditions and what the corresponding ABGs will usually look like. For example, let's say a COPD patient has high pCO2s and close to normal pO2s this would indicate more of a ventilation problem. However if that same patient had low pO2s as well then he would actually have both a ventilation and oxygenation problem. So each disease process is actually on a continuum and cannot be place in one category or the other. Asthma starts out as a ventilation problem (narrow airways don't move air well) that as it continues down the disease course will become an oxygenation problem as well (alveoli collapse). Pneumonia usually starts as an oxygenation problem (fluid in alveolar sacs) but may progress to be a ventilatory problem as the disease worsens. Sleep apnea is obviously ventilatory but again the end result will be poor oxygenation. I think your (the OP's) confusion may lie in the term "ventilation" which actually has more than one meaning and can be a noun a verb and, just to make it more confusing, an adverb depending on the context in which it is being used. It can mean the actual movement of inhaling and exhaling but also what happens at the alvolar level with the exchange of CO2, or it can mean your dorm room has plenty of fresh air!

[FlyingScot, RN]

I know my daughters small spontaneous pneumothorax at birth was treated with just oxygen... that may be another scenario for you to include.

That actually is a different thing. Your daughter was treated with what is sometimes called a "Nitrogen Washout" which is a common practice in treating neonates with small pneumos. Her oxygenation was probably fine. In this procedure the infant is given high concentrations of oxygen regardless of SaO2 readings. The O2 molecules flow into the pleural space, where the trapped air is, displacing the nitrogen molecules. O2 molecules are more readily absorbed by the tissues than nitrogen so when the trapped air becomes oxygen rich it gets absorbed faster and as a result reduces in volume thereby decreasing the size of the pneumo.

However if you want to categorize pneumos you can look at it as a ventilatroy problem (no or reduced amount of flow of air into lung due to compression) that becomes an oxygenation problem (no air=no O2 to the alveoli) that becomes a different kind of ventilatory problem (decreased number of alveoli available to the capillaries to allow for diffusion of CO2 and eventual removal of it from the body) that leads to a worsening oxygenation problem and if the person is not treated leads back to the original type of ventilatory problem only this time it would be the result of apnea!

[RNTutor, BSN, RN]

FlyingScot: Yes, it does make more sense differentiating oxygenation and ventilation when you explain it that way. And thanks for the overview on Nitrogen washes, I wasn't familiar with them before and learned something new!