Published May 14, 2004
Can someone explain pulmonary shunting to me. I am reading a couple of articles on ARDS and they talk about pulmonary shunting, but without explanation. Is this just blood being shunted away from the areas of alveoli collapse to other areas of the lungs? If so, can that cause flash pulmonary edema or right-sided heart failure?
Pulmonary shunting is blood that does not get any gas exchange at the alveolar level. It passes by the collapsed alveoli and is not able to complete the gas exchange. Think of it as a freeway with no exits (collapsed alveoli) - no place for the 02 to get off. When the alveoli are open and functional, the freeway has plenty of exit ramps for gas exchange. Pulmonary shunting will not cause flash pulmonary edema or right sided heart failure, but ARDS can. Hope this helps.
Thanks surfer girl! I like the analogy. Makes it easy to understand.
Gompers, BSN, RN
I work in NICU, so I was wondering what they use in adult ICUs for this condition? We use nitric oxide on babies with good success.
chaosRN, ASN, RN
This bring up an issue I don't quite understand. Why does high doses of Nipride cause pulmonary shunting? Is is because of the constriction to vessels & arteries?? People at work can't really explain it well, or I'm just not understanding. :)
We use nitric on adults as well, at least once a month sometimes more.
Nipride is a VERY potent venous and arterial vasodilator. It can potentiate Right to left shunting.
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