In COVID-19-ARDS, we expect a higher V/Q ratio due to pulmonary microthrombosis and the higher aerated lung fraction. Ventilation perfusion mismatch due to low-ventilation/perfusion (V/Q) ratio leads to venous admixture. Furthermore, venous admixture was also noted in COVID-19-ARDS patients with low non-aerated lung fraction. ARDS due to coronavirus disease 2019 (COVID-19) had a lower P/F (PaO 2/FiO 2) ratio than compliance-matched-ARDS despite having a lower non-aerated lung volume. However, their physiological justification needs some more introspection.
This paper compared respiratory mechanics in acute respiratory distress syndrome (ARDS) phenotypes and observed several interesting clinico-physiologic contradictions. recently published in Intensive Care Medicine. This letter is in response to an article by Chiumello et al.
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