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Hypoxia and Happy Hypoxia
This article discusses different types of hypoxia. Here, learn about the tests, procedures, indications, and more.
Keywords: hypoxia | happy hypoxia | silent hypoxia | hypoxic hypoxia | anemic hypoxia | histotoxic hypoxia | stagnant hypoxia | Oxygen therapy | Hyperbaric Oxygen therapy | COVID-19 | ARDS.
Table of contents
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Introduction |
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Classification |
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Clinical |
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Here you will find human Physiology, Anatomy, and health-related topics.
Definition: when body tissues get reduced oxygen supply, it is hypoxia. In hypoxemia, the oxygen supply is insufficient. It may be
1. Generalized –in which the whole body is affected and
2. Local –in which a part of the body is affected. It may become generalized.
Anoxia is the complete cessation of oxygen supply to the tissue.
Hypoxia is different from hypoxemia.
In hypoxemia, the arterial oxygen concentration is low.
Anoxemia is a state of zero arterial oxygen supply.
Happy hypoxia or Silent hypoxia:
This is a condition in which the oxygen level in blood cells and tissues drops to a dangerous level, as low as 40%, without any warning signs or symptoms.
Patients feel happy and comfortable. Their body adjusts for a short time to these low levels of oxygen. However, after some time, these adjustments fail, and patients become critical. In COVID-19 patients, oxygen levels fall to such a degree that patients go into acute respiratory distress (ARDS), and organ failure occurs. Even sudden death occurs. Silent hypoxia is reported in COVID-19 patients without warning signs, such as coughing, dizziness, altered sensorium, etc.
In COVID-19 patients, symptoms of hypoxia that did not appear early are not explained by any theory. One theory states that the body adjusts to these low oxygen levels for a short time, just like when one ascends to a high altitude- acclimatization. Another theory states that in COVID-19, patients' air sacs of lungs collapse, and oxygen levels reduce, but the average human ability to expel carbon dioxide is maintained. Therefore, the carbon dioxide level is within the average level; therefore, the brain fails to recognize hypoxia in the initial stage.
It is crucial to detect happy hypoxia and provide prompt and immediate care to save lives.
How to recognize happy hypoxia:
A pulse oximeter can measure blood saturation levels. A pulse oximeter is a gadget to estimate oxygen saturation in blood and heart rate by a non-invasive method. Pulse oximetry is easy to operate.
Smartphone-based pulse oximetry is also present, which is accurate when oxygen saturation is above 90%. Hypoxia is easily recognized. In COVID-19, the patient's oxygen level is checked 5 times daily. When oxygen saturation is below 94%, it is a severe condition.
One must note the presence of cardinal signs and symptoms of hypoxia: lips will appear blue, skin discolored to red or purple, and profuse sweating without apparent cause.
In severe hypoxia, ataxia, confusion, hallucination, disorientation, severe headache, breathlessness, pallor, cyanosis, tachycardia shock, and death may occur. In addition, hypoxia has harmful effects on all organs of the body.
The oxygen mixed with water vapor passively diffuses from the breathed air to arterial blood. In the arterial blood, partial oxygen pressure is 100 mm of mercury. In the blood, oxygen combines with hemoglobin in the red blood cells.
1 gm of hemoglobin combines with 1.34 ml of oxygen in normal conditions. A negligible (0.3 ml of oxygen /dl of blood )amount of oxygen is dissolved in the blood and transported in solution. So, hemoglobin carries all oxygen in the body. The binding capacity of hemoglobin oxygen depends on the partial pressure of oxygen present in the atmosphere.
At sea level, atmospheric pressure is considered as one, which is 760 mm of mercury. In the atmosphere, 20.95%=21% oxygen and 0.4%water vapor are present.
In the peripheral tissue, oxygen diffuses against the pressure gradient into the cells. In the cell's mitochondria, oxygen is utilized by the cytochrome system.
Hypoxia may result from the following defects:
1. Reduced partial pressure of oxygen.
2. Difficulty of oxygen diffusion in the lungs.
3. Less amount of hemoglobin to carry oxygen
4. Difficulty in blood flow to the tissue and
5. Defect in oxygen utilization by the tissue.
The oxygen diffusion becomes rate-limiting and lethal when the partial pressure of oxygen deepens below 60 mm of mercury.
Classification of hypoxemia :
1. Hypoxic hypoxia
2. Anaemic hypoxia
3. Stagnant hypoxia
4. Histotoxic hypoxia
Hypoxic hypoxia occurs due to low partial pressure of oxygen in inspired air at a high altitude or breathing in a closed space. Low arterial partial pressure occurs when there is airway obstruction, depression of respiratory centers by drugs, weakness of respiratory muscles, venous arterial shunts, or defects in gaseous exchange in the lungs. It will cause low arterial oxygen.
Anemic hypoxia: Haemoglobin carries all the oxygen in the body. The partial pressure of atmospheric oxygen affects hemoglobin binding capacity. When hemoglobin concentration is reduced, the oxygen-carrying ability of the blood is diminished, causing anemic hypoxia. Anemia due to any cause will cause anemic hypoxia.
Stagnant hypoxia or ischaemic hypoxia: In this type of hypoxia, blood flow to the tissue is prolonged, unable to provide the requisite amount of oxygen to the tissue. The conditions causing stagnant hypoxia are circulatory failure and congestive heart failure.
Histotoxic hypoxia: In histotoxic hypoxia, cells fail to utilize oxygen due to some toxin. The most common agent causing histotoxic hypoxia is cyanide. The cytochrome oxidase is blocked by cyanide, and cells cannot use oxygen.
Symptoms of hypoxia: Nausea, vomiting, drowsiness, headache, tremors, palpitation, Impaired mental functions
Signs: Tachycardia, hypertension, tachypnea, increased depth of respiration.
It is not easy to estimate the partial pressure of oxygen in arterial blood. But SpO2 is easily determined by a pulse oximeter.
The average level of SpO2 is 94 to 100%. If it is below 90%, it needs attention, and treatment is required. SpO2 falls below 60%, which will cause unconsciousness, followed by death in 3 to 5 minutes. This is because brain tissue cannot withstand hypoxia for 3 minutes.
Management of hypoxia will depend on the cause. For example, in the case of Anaemic hypoxia, treatment is directed to raise the hemoglobin. In the case of congestive heart failure, the cause of the disease is treated.
Use of Oxygen: Oxygen is a drug, and its reasonable use is essential. It can make or break the machinery.
Newborns are susceptible to oxygen. Oxygen toxicity will develop if more than 40% oxygen inhalation is given. Retroplacental fibroplasia causing permanent blindness and bronchopulmonary dysplasia are ubiquitous manifestations of oxygen toxicity.
Simple Oxygen therapy is not beneficial when hypoxic hypoxia is suspected. However, administering 80-100% oxygen at one atmospheric pressure is valuable in hypoxic hypoxia.
Hyperbaric Oxygen therapy is helpful in all types of hypoxia (Anaemic hypoxia, Stagnant hypoxia, Histotoxic hypoxia) except Hypoxic hypoxia. Hyperbaric Oxygen therapy will increase the oxygen content in dissolved form.
Typically, dissolved oxygen is 0.3 ml/dl of blood /100 mm Hg pO2 .oxygen toxicity develops rapidly, characterized by dizziness and loss of consciousness.
Hashtags: hypoxia # happy hypoxia # silent hypoxia # hypoxic hypoxia # anemic hypoxia # histotoxic hypoxia # stagnant hypoxia # Oxygen therapy # Hyperbaric Oxygen therapy # COVID-19 # ARDS
Summary
Classification of hypoxemia :
1. Hypoxic hypoxia
2. Anaemic hypoxia
3. Stagnant hypoxia
4. Histotoxic hypoxia
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FAQ :
Q. What is hypoxemia?
A. When the arterial oxygen concentration is low, it is known as hypoxemia.
Q. What is happy hypoxia?
A. Happy hypoxia or Silent hypoxia: In this condition, the oxygen level in blood cells and tissues drops to a dangerous level, as low as 40%, without any warning signs or symptoms.
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Internal links:
https://blog.totalphysiology.com/2022/10/cyanosis.html
https://blog.totalphysiology.com/2022/08/lung-volumes-pulmonary-functions.html
https://blog.totalphysiology.com/2021/12/red-blood-cell-erythropoeisis.html
External links:
https://www.ncbi.nlm.nih.gov/books/NBK482316/
https://en.m.wikipedia.org/wiki/Hypoxia_%28medical%29
Thanks,for such article,very useful for me.
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