Pulmonary Embolism and Gas Exchange

Respiration. 2019;98(3):253-262. doi: 10.1159/000501342. Epub 2019 Aug 7.

Abstract

Acute pulmonary embolism (PE) impairs hemodynamics, gas exchange, and lung mechanical capacity. Considering PE pathophysiology, most attention has been paid to hemodynamic impairment. However, the most prevalent symptoms in PE patients come from gas exchange alterations, which have not been in the spotlight for many years. Pulmonary physiology and consequent gas exchange impairment play a pivotal role in the high risk of death from PE. In this review, we will look at the pathophysiology of PE, from the vascular occlusion to the resultant heterogeneity in pulmonary perfusion and gas exchange impairment, discussing in detail its causes and consequences.

Keywords: Dead space; Gas exchange; Hypocapnia; Hypoxia; Pulmonary embolism; V/Q mismatch.

Publication types

  • Review

MeSH terms

  • Carbon Dioxide / metabolism*
  • Carbon Monoxide
  • Hemodynamics
  • Humans
  • Hypertension, Pulmonary / metabolism
  • Hypertension, Pulmonary / physiopathology
  • Hypoxia / metabolism
  • Hypoxia / physiopathology*
  • Pulmonary Circulation / physiology
  • Pulmonary Diffusing Capacity
  • Pulmonary Embolism / metabolism
  • Pulmonary Embolism / physiopathology*
  • Pulmonary Gas Exchange / physiology*
  • Pulmonary Ventilation
  • Vascular Resistance / physiology

Substances

  • Carbon Dioxide
  • Carbon Monoxide