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Related Experiment Video

Updated: Jun 7, 2025

A Model to Simulate Clinically Relevant Hypoxia in Humans

A Model to Simulate Clinically Relevant Hypoxia in Humans

Published on: December 22, 2016

Paradoxical Hypoxemia Following Positive Pressure Ventilation: Exploring the Pathophysiology.

Xin Ya See¹, Zehra Naseem², Susan Synderburn³

¹Department of Medicine, Unity Hospital, Rochester Regional Health, Rochester, USA.

European Journal of Case Reports in Internal Medicine

|November 11, 2024

Summary

This summary is machine-generated.

Positive pressure ventilation can cause paradoxical hypoxemia in patients with a patent foramen ovale (PFO). Recognizing this shunt is crucial for adjusting ventilation settings and improving oxygenation.

Keywords:

Hypoxemia patent foramen ovale positive pressure ventilation shunt

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A Model to Simulate Clinically Relevant Hypoxia in Humans

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Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department

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Normothermic Negative Pressure Ventilation Ex Situ Lung Perfusion: Evaluation of Lung Function and Metabolism

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Published on: February 14, 2022

Area of Science:

Cardiology
Pulmonology
Critical Care Medicine

Background:

Positive pressure ventilation (PPV) improves gas exchange but can paradoxically worsen hypoxemia.
Underlying intracardiac shunts, like a patent foramen ovale (PFO), can complicate PPV.
A case of unexplained hypoxemia during bilevel positive airway pressure (BiPAP) therapy is presented.

Purpose of the Study:

To describe a case of paradoxical hypoxemia during BiPAP.
To highlight the role of a right-to-left interatrial shunt in this phenomenon.
To emphasize the importance of individualized BiPAP management.

Main Methods:

Case report of a 58-year-old female with systemic lupus erythematosus, interstitial lung disease, and pulmonary embolism.
Initiation of BiPAP for respiratory support.
Diagnostic investigation revealing a right-to-left interatrial shunt via PFO.
Adjustment of BiPAP settings based on hemodynamic assessment.

Main Results:

BiPAP improved hypercarbia but exacerbated hypoxemia.
A patent foramen ovale (PFO) was identified as the cause of paradoxical hypoxemia.
Optimized BiPAP settings led to improved arterial blood gas parameters.

Conclusions:

Positive pressure ventilation can precipitate paradoxical hypoxemia in patients with PFO.
Intracardiac shunts should be considered in unexplained hypoxemia during PPV.
Tailoring BiPAP settings to individual hemodynamics is vital for effective oxygenation.