Which conditions are associated with hypoxia despite mechanical ventilation?

Updated: Sep 15, 2020
  • Author: Christopher D Jackson, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Inadequate oxygenation despite the administration of 100% oxygen should lead to a search for complications of endotracheal intubation (eg, right mainstem intubation) or positive-pressure breathing (pneumothorax). If such complications are not present, PEEP is needed to treat the intrapulmonary shunt pathology. Because only a few disease processes can create an intrapulmonary shunt, a clinically significant estimated shunt should narrow the potential source of hypoxemia to the following conditions:

  • Alveolar collapse - Major atelectasis

  • Alveolar filling with something other than gas - Lobar pneumonia

  • Water and protein - ARDS

  • Water - Congestive heart failure

  • Blood - Hemorrhage

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