![]() (1) Inhaled pulmonary vasodilators may drop the pressure in the right atrium.Inhaled pulmonary vasodilators will tend to reduce blood flow through this shunt, for a few reasons:.The most notable scenario here might be a patient with pulmonary hypertension and a patent foramen ovale (PFO), leading to an intracardiac right-to-left shunt that causes systemic hypoxemia.This is similar to #2 above, but it will occur only in patients who are experiencing shunting of deoxygenated blood into the systemic circulation (which is less common than ventilation-perfusion mismatch).#3) reduced blood flow through a right-to-left shunt This partially underlies the utility of pulmonary vasodilators in ARDS. The most well-known consequence of improved ventilation-perfusion matching is improved oxygenation.This directs blood flow preferentially towards better ventilated areas, improving ventilation-perfusion matching. Inhaled pulmonary vasodilators will tend to be distributed to well-ventilated alveoli, where they cause local vasodilation.#2) improved ventilation-perfusion (V/Q) matching ![]() Reducing pulmonary vascular resistance is beneficial for patients with increased pulmonary vascular resistance (pulmonary hypertension) and/or impaired right ventricle function (e.g., right ventricular myocardial infarction).This causes afterload reduction for the right ventricle. Pulmonary vasodilation will reduce the resistance of the pulmonary vascular bed.Inhaled pulmonary vasodilators yield three physiological advantages: #1) reduced pulmonary vascular resistance Physiologic effects of inhaled pulmonary vasodilators
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