Open AccessMechanisms of Hypoxia in COVID-19 Patients: A Pathophysiologic Reflection
Author(s) -
Mohaitsure,
Bhakti Sarangi,
Guruprasad Hassan Shankar,
Venkat Sandeep Reddy,
Ajay Walimbe,
Varsha Sharma,
Shirish Prayag
Publication year - 2020
Publication title -
indian journal of critical care medicine/indian journal of critical care medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.317
H-Index - 30
eISSN - 1998-359X
pISSN - 0972-5229
DOI - 10.5005/jp-journals-10071-23547
Subject(s) - medicine , pathophysiology , ards , hypoxemia , hypoxia (environmental) , covid-19 , lung , cardiology , pathology , disease , infectious disease (medical specialty) , oxygen , chemistry , organic chemistry
Coronavirus disease-2019 (COVID-19) causes severe hypoxemia which fulfills the criteria of acute respiratory distress syndrome (ARDS) but is not accompanied by typical features of the syndrome. The combination of factors including low P/F ratios, high A-a gradient, relatively preserved lung mechanics, and normal pulmonary pressures may imply a process occurring on the vascular side of the alveolar-capillary unit. The scant but rapidly evolving data available on the pathophysiology are seemingly conflicting, indicating the relative dominance of intrapulmonary shunting or dead space in different studies. In this hypothesis paper, we attempt to gather and explain these observations within a unified conceptual framework by invoking the relative contributions of microvascular thrombosis, along with two proposed vascular mechanisms of capillary flow redistribution and flow through intrapulmonary arteriovenous anastomoses (IPAVA). How to cite this article: Nitsure M, Sarangi B, Shankar GH, Reddy VS, Walimbe A, Sharma V, et al. Mechanisms of Hypoxia in COVID-19 Patients: A Pathophysiologic Reflection. Indian J Crit Care Med 2020;24(10):967-970.