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Updated: Jul 1, 2025

Shunt Surgery, Right Heart Catheterization, and Vascular Morphometry in a Rat Model for Flow-induced Pulmonary Arterial Hypertension
Published on: February 11, 2017
Pulmonary shunt in critical care: a practical approach with clinical scenarios
Davide Raimondi Cominesi1, Mario Forcione1, Matteo Pozzi1,2
1School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
Background:
Pulmonary shunt refers to the passage of venous blood into the arterial blood system bypassing the alveoli-blood gas exchange. Pulmonary shunt is defined by a drop in the physiologic coupling of lung ventilation and lung perfusion. This may consequently lead to respiratory failure.
Main Body:
The pulmonary shunt assessment is often neglected. From a mathematical point of view, pulmonary shunt can be assessed by estimating the degree of mixing between oxygenated and deoxygenated blood. To compute the shunt, three key components are analyzed: the oxygen (O2) content in the central venous blood before gas exchange, the calculated O2 content in the pulmonary capillaries after gas exchange, and the O2 content in the arterial system, after the mixing of shunted and non-shunted blood. Computing the pulmonary shunt becomes of further importance in patients on extracorporeal membrane oxygenation (ECMO), as arterial oxygen levels may not directly reflect the gas exchange of the native lung.
Conclusion:
In this review, the shunt analysis and its practical clinical applications in different scenarios are discussed by using an online shunt simulator.
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