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What is The alveolar aerial gradient is highest in which of the following? and explain in detail?
The alveolar aerial PO2 difference is obtained by subtracting the aerial PO2 from the alveolar PO2. The normal alveolar-arial PO2 gradient is between 5-15 mm Hg.The alveolar aerial gradient is useful measure of ventilation perfusion mismatch. ILD- Due to pulmonary fibrosis, diffusion defect will lead to significant reduction in value of paO2. Hence the gradient will show an increase. Pulmonary embolism- Due to V/P mismatch in PE, the value of paO2 is normal to reduced. In massive PE, the gradient is definitely increased. There is adequat ventilation but zero perfusion , the V/Q ratio is infinite.At a ratio of infinity, there is no exchange of gases through the respiratory membrane of affected alveoli. Acute severe asthma- Due to severe airflow limitation both paO2 and pAO2 are reduced leading to normal alveolar aerial gradient. FB leading to upper airway obstruction- Due to severe airflow limitation both paO2 and pAO2 are reduced leading t normal alveolar aerial gradient.