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Intrapulmonary shunt

MedGen UID:
1614836
•Concept ID:
C0489642
•
Finding
Synonyms: Intrapulmonary Shunt; Intrapulmonary shunting
 
HPO: HP:0031225

Definition

Blood flow through a region of the lung in which little or no ventilation takes place, resulting in reduced oxygenation of the blood leaving the lungs. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVIntrapulmonary shunt

Professional guidelines

PubMed

Management for the Drowning Patient.
Szpilman D, Morgan PJ
Chest 2021 Apr;159(4):1473-1483. Epub 2020 Oct 14 doi: 10.1016/j.chest.2020.10.007. PMID: 33065105
Management of refractory hypoxemia during venovenous extracorporeal membrane oxygenation for ARDS.
Montisci A, Maj G, Zangrillo A, Winterton D, Pappalardo F
ASAIO J 2015 May-Jun;61(3):227-36. doi: 10.1097/MAT.0000000000000207. PMID: 25923575
Inhaled nitric oxide in the treatment of hypoxemic respiratory failure.
Kass LJ, Apkon M
Curr Opin Pediatr 1998 Jun;10(3):284-90. doi: 10.1097/00008480-199806000-00011. PMID: 9716891

Recent clinical studies

Etiology

Intrapulmonary shunt and alveolar dead space in a cohort of patients with acute COVID-19 pneumonitis and early recovery.
Harbut P, Prisk GK, Lindwall R, Hamzei S, Palmgren J, Farrow CE, Hedenstierna G, Amis TC, Malhotra A, Wagner PD, Kairaitis K
Eur Respir J 2023 Jan;61(1) Epub 2023 Jan 27 doi: 10.1183/13993003.01117-2022. PMID: 36137595Free PMC Article
Fifty Years of Research in ARDS. Gas Exchange in Acute Respiratory Distress Syndrome.
Radermacher P, Maggiore SM, Mercat A
Am J Respir Crit Care Med 2017 Oct 15;196(8):964-984. doi: 10.1164/rccm.201610-2156SO. PMID: 28406724
Intrapulmonary shunt and SCUBA diving: another risk factor?
Madden D, Ljubkovic M, Dujic Z
Echocardiography 2015 Feb;32 Suppl 3:S205-10. doi: 10.1111/echo.12815. PMID: 25693625
Pulmonary arteriovenous malformations.
Cartin-Ceba R, Swanson KL, Krowka MJ
Chest 2013 Sep;144(3):1033-1044. doi: 10.1378/chest.12-0924. PMID: 24008954
Pulmonary pathophysiology of pneumococcal pneumonia.
Light RB
Semin Respir Infect 1999 Sep;14(3):218-26. PMID: 10501309

Diagnosis

Fifty Years of Research in ARDS. Gas Exchange in Acute Respiratory Distress Syndrome.
Radermacher P, Maggiore SM, Mercat A
Am J Respir Crit Care Med 2017 Oct 15;196(8):964-984. doi: 10.1164/rccm.201610-2156SO. PMID: 28406724
Intrapulmonary shunt and SCUBA diving: another risk factor?
Madden D, Ljubkovic M, Dujic Z
Echocardiography 2015 Feb;32 Suppl 3:S205-10. doi: 10.1111/echo.12815. PMID: 25693625
Pulmonary arteriovenous malformations.
Cartin-Ceba R, Swanson KL, Krowka MJ
Chest 2013 Sep;144(3):1033-1044. doi: 10.1378/chest.12-0924. PMID: 24008954
Pulmonary pathophysiology of pneumococcal pneumonia.
Light RB
Semin Respir Infect 1999 Sep;14(3):218-26. PMID: 10501309
The hepatopulmonary syndrome.
Lange PA, Stoller JK
Ann Intern Med 1995 Apr 1;122(7):521-9. doi: 10.7326/0003-4819-122-7-199504010-00008. PMID: 7872588

Therapy

Impact of pharmacological interventions on intrapulmonary shunt during one-lung ventilation in adult thoracic surgery: a systematic review and component network meta-analysis.
Schorer R, Dombret AL, Hagerman A, Bédat B, Putzu A
Br J Anaesth 2023 Jan;130(1):e92-e105. Epub 2022 Oct 26 doi: 10.1016/j.bja.2022.08.039. PMID: 36939497
Dopamine Reverses Lung Function Deterioration After Cardiopulmonary Bypass Without Affecting Gas Exchange.
Peták F, Balogh ÁL, Hankovszky P, Fodor GH, Tolnai J, Südy R, Kovács BN, Molnár A, Babik B
J Cardiothorac Vasc Anesth 2022 Apr;36(4):1047-1055. Epub 2021 Jul 24 doi: 10.1053/j.jvca.2021.07.033. PMID: 34404593
Longterm Outcome of Liver Transplantation for Congenital Extrahepatic Portosystemic Shunt.
Uchida H, Sakamoto S, Kasahara M, Kudo H, Okajima H, Nio M, Umeshita K, Ohdan H, Egawa H, Uemoto S; Japanese Liver Transplantation Society
Liver Transpl 2021 Feb;27(2):236-247. Epub 2020 Aug 6 doi: 10.1002/lt.25805. PMID: 32463947
Rotational bed therapy to prevent and treat respiratory complications: a review and meta-analysis.
Goldhill DR, Imhoff M, McLean B, Waldmann C
Am J Crit Care 2007 Jan;16(1):50-61; quiz 62. PMID: 17192526
Adult respiratory distress syndrome.
Dal Nogare AR
Am J Med Sci 1989 Dec;298(6):413-30. doi: 10.1097/00000441-198912000-00011. PMID: 2688415

Prognosis

Increased intrapulmonary shunt and alveolar dead space post-COVID-19.
Farrow CE, Robles RA, Prisk GK, Harbut P, Malhotra A, Amis TC, Wagner PD, Kairaitis K
J Appl Physiol (1985) 2023 Nov 1;135(5):1012-1022. Epub 2023 Sep 28 doi: 10.1152/japplphysiol.00267.2023. PMID: 37767555Free PMC Article
Pulmonary arteriovenous malformations.
Cartin-Ceba R, Swanson KL, Krowka MJ
Chest 2013 Sep;144(3):1033-1044. doi: 10.1378/chest.12-0924. PMID: 24008954
Pulmonary pathophysiology of pneumococcal pneumonia.
Light RB
Semin Respir Infect 1999 Sep;14(3):218-26. PMID: 10501309
The hepatopulmonary syndrome.
Lange PA, Stoller JK
Ann Intern Med 1995 Apr 1;122(7):521-9. doi: 10.7326/0003-4819-122-7-199504010-00008. PMID: 7872588
Perioperative functional residual capacity.
Wahba RW
Can J Anaesth 1991 Apr;38(3):384-400. doi: 10.1007/BF03007630. PMID: 2036700

Clinical prediction guides

Increased intrapulmonary shunt and alveolar dead space post-COVID-19.
Farrow CE, Robles RA, Prisk GK, Harbut P, Malhotra A, Amis TC, Wagner PD, Kairaitis K
J Appl Physiol (1985) 2023 Nov 1;135(5):1012-1022. Epub 2023 Sep 28 doi: 10.1152/japplphysiol.00267.2023. PMID: 37767555Free PMC Article
Hyperoxia may be beneficial.
Calzia E, Asfar P, Hauser B, Matejovic M, Ballestra C, Radermacher P, Georgieff M
Crit Care Med 2010 Oct;38(10 Suppl):S559-68. doi: 10.1097/CCM.0b013e3181f1fe70. PMID: 21164398
Intrapulmonary shunt during normoxic and hypoxic exercise in healthy humans.
Lovering AT, Stickland MK, Eldridge MW
Adv Exp Med Biol 2006;588:31-45. doi: 10.1007/978-0-387-34817-9_4. PMID: 17089877
The hepatopulmonary syndrome.
Lange PA, Stoller JK
Ann Intern Med 1995 Apr 1;122(7):521-9. doi: 10.7326/0003-4819-122-7-199504010-00008. PMID: 7872588
Perioperative functional residual capacity.
Wahba RW
Can J Anaesth 1991 Apr;38(3):384-400. doi: 10.1007/BF03007630. PMID: 2036700

Recent systematic reviews

Impact of pharmacological interventions on intrapulmonary shunt during one-lung ventilation in adult thoracic surgery: a systematic review and component network meta-analysis.
Schorer R, Dombret AL, Hagerman A, Bédat B, Putzu A
Br J Anaesth 2023 Jan;130(1):e92-e105. Epub 2022 Oct 26 doi: 10.1016/j.bja.2022.08.039. PMID: 36939497
Comparison of pressure-controlled ventilation with volume-controlled ventilation during one-lung ventilation: a systematic review and meta-analysis.
Kim KN, Kim DW, Jeong MA, Sin YH, Lee SK
BMC Anesthesiol 2016 Aug 31;16(1):72. doi: 10.1186/s12871-016-0238-6. PMID: 27581657Free PMC Article
Intravenous versus inhalation anaesthesia for one-lung ventilation.
Módolo NS, Módolo MP, Marton MA, Volpato E, Monteiro Arantes V, do Nascimento Junior P, El Dib RP
Cochrane Database Syst Rev 2013 Jul 11;2013(7):CD006313. doi: 10.1002/14651858.CD006313.pub3. PMID: 23846831Free PMC Article

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