Regions with V/Q Any regional cause of V/Q >1 or V/Q Posture – more scatter upright > supine > prone.A sophisticated knowledge based on theĬhapter in Nunn is a minimum standard expected for this topic. It is core knowledge for Intensive Care Specialists managing respiratory failure. Often graphs were reproduced inaccurately and contradictory statements made, leaving the impression that candidates did not understand the basic concepts. The shape of the oxy-Hb dissociation curve and CO2-dissociation curve were sometimes mentioned but their effect on arterial gas tensions not well explained. The differential effect of FiO2 on true shunt versus V/Q scatter was seldom explained. The inability of high V/Q areas to compensate for low V/Q zones owing to the relatively small contribution of blood flow from these high V/Q units was not discussed. V/Q scatter as well as true shunt (V/Q=0) and dead space (V/Q=∞) needed to be considered.
Candidates did not accurately define V/Q inequality and the physiological factors causing this phenomenon. Very few candidates demonstrated understanding of this core topic.
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