Hypoxia is a lack of oxygen at the tissue level. The main types are hypoxic (low oxygen in blood), anemic (low oxygen carrying capacity), stagnant (low blood flow), and histotoxic (tissues can't use oxygen). Symptoms include dyspnea and cyanosis. Cyanosis occurs when reduced hemoglobin in blood exceeds 5g/dL, seen commonly in the fingertips, lips, and tongue. Central cyanosis is due to low arterial oxygenation while peripheral cyanosis is due to low blood flow. Asphyxia combines hypoxia and hypercapnia due to impaired respiration.
Hypoxia is a lack of oxygen at the tissue level. The main types are hypoxic (low oxygen in blood), anemic (low oxygen carrying capacity), stagnant (low blood flow), and histotoxic (tissues can't use oxygen). Symptoms include dyspnea and cyanosis. Cyanosis occurs when reduced hemoglobin in blood exceeds 5g/dL, seen commonly in the fingertips, lips, and tongue. Central cyanosis is due to low arterial oxygenation while peripheral cyanosis is due to low blood flow. Asphyxia combines hypoxia and hypercapnia due to impaired respiration.
Hypoxia is a lack of oxygen at the tissue level. The main types are hypoxic (low oxygen in blood), anemic (low oxygen carrying capacity), stagnant (low blood flow), and histotoxic (tissues can't use oxygen). Symptoms include dyspnea and cyanosis. Cyanosis occurs when reduced hemoglobin in blood exceeds 5g/dL, seen commonly in the fingertips, lips, and tongue. Central cyanosis is due to low arterial oxygenation while peripheral cyanosis is due to low blood flow. Asphyxia combines hypoxia and hypercapnia due to impaired respiration.
Hypoxia is a lack of oxygen at the tissue level. The main types are hypoxic (low oxygen in blood), anemic (low oxygen carrying capacity), stagnant (low blood flow), and histotoxic (tissues can't use oxygen). Symptoms include dyspnea and cyanosis. Cyanosis occurs when reduced hemoglobin in blood exceeds 5g/dL, seen commonly in the fingertips, lips, and tongue. Central cyanosis is due to low arterial oxygenation while peripheral cyanosis is due to low blood flow. Asphyxia combines hypoxia and hypercapnia due to impaired respiration.
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HYPOXIA
Respiratory Physiology Definitions Hypoxia : Hypoxia is defined as lack of oxygen at tissue level.
Anoxia : Anoxia is defined as complete absence of oxygen in the tissues Objectives At the end of the session the students should be able to: • Define and classify Hypoxia, List its causes and describe its associated and compensatory changes. • Define Cyanosis and mention its types and causes • Define Cheyne- Stokes breathing and describe its pathophysiology Types of hypoxia HYPOXIA Based on 1. Hypoxic hypoxia Oxygen tension in arterial blood
2. Anemic Hypoxia Oxygen carrying capacity of blood
3. Stagnant hypoxia Rate of blood flow
4. Histotoxic hypoxia Utilization of oxygen by the cells
•Each type of hypoxia may be acute or chronic.
•Simultaneously 2 or more types may be present • 1. HYPOXIC HYPOXIA ( arterial hypoxia):
Characterized by a low arterial PO2, when O2 carrying capacity of blood
and rate of blood flow are normal.
CAUSES 1. Low PO2 in inspired air : eg. Mines , high altitude, closed chamber.
2. Hypoventilation :eg. Air way obstruction, paralysis of respiratory muscle depression of respiratory center (drugs)
Hypoxia in which arterial PO2 is normal but the amount of
Haemoglobin available to carry 02 is reduced.
Causes: 1. Decreased number of RBC’s 2. Decreased Hb content in the blood 3. Formation of altered Hb 4. Combination of hemoglobin with gases other than oxygen and carbon dioxide 3. Stagnant ( ischaemic) hypoxia:
Hypoxia in which the blood flow to the tissues is so slow that
adequate O2 is not delivered to them despite a normal arterial PO2 and Hb concentration.
Hypoxia in which the amount of oxygen delivered to the tissue is
adequate, but because of the action of toxic agents the tissue cells cannot make use of the O2 supplied to them.
Causes: • Occurs due to cyanide or sulfide poisoning • Poisonous substances destroy the cellular oxidative enzymes Type of hypoxia Hypoxic Anemic Stagnant Histotoxic
Oxygen content in the blood Reduced Reduced Normal Normal
Arterial PO2 Reduced Normal Normal Normal
Oxygen carrying capacity Normal Reduced Normal Normal
Hemoglobin saturation of Reduced Reduced Normal Normal
blood or normal
Rate of blood flow to tissue Normal Normal Reduced Normal
O2 utilization by tissue Normal Normal Normal Reduced
• OXYGEN THERAPY DURING HYPOXIA
• 1. By placing the patients head in a tent
containing air with pure oxygen • 2. By allowing the patient to breathe high concentrations of oxygen or pure oxygen either from the mask or intranasal tube Asphyxia • Condition where lack of O2 is combined with CO2 excess.
• Produced by any condition which prevents
adequate aeration of blood.
• Results in hypoxia & hypercapnia.
• Usually due to mechanical interference with
respiration. Conditions:
• Suffocation, • strangulation, • drowning, • foreign body in the trachea or larynx, • traumatic compression of the chest Stages of Asphyxia 1. Stage of exaggerated breathing: • Breathing becomes deeper and rapid (powerful stimulation of respiratory center by excess CO2 stimulation ) • Accessory respiratory muscle participate • Dysnoea and cyanosis occur • Eyes become prominent • Phase lasts for 1-2 min 2. Stage of convulsion:
• Expiratory effort becomes violent
• Generalised muscular convulsion appear • Tachycardia • Intense vasoconstriction • Rise in BP • Consciousness is lost • Lasts for about a minute 3. Stage of exhaustion and collapse
• Depression of the center
• Convulsions ceases abruptly • Respiratory gasping occurs, stretches its body and opens mouth widely for breath • Pupils are widely dialated • Pulse becomes feeble • Reflexes abolished • Pause between gasp increases • Lasts for about 5 miniute Periodic breathing
• Abnormal or uneven respiratory rhythm
2 types: 1. cheyne- strokes breathing 2. Biot’s breathing Cheyne-stokes breathing • This is characterized by gradual waxing and waning followed by a period of apnoea
Apnoea hypernapnoea • Seen in : 1. Premature infants 2. Unacclimatized persons at high altitude 3. During deep sleep in some 4. Voluntary hyperventilation 5. Increased intracranial pressure 6. Renal failure 7. Heart failure Biots breathing: Apnoea and hypernoea are abrupt. No waxing and waning seen Seen in : Increased intra cranial pressure Morphine poisoning Damage to brain stem Biot’s breathing • Characterized by period of apnea and hyperpnea • There is no waxing and weaning period • After apneic period , hyperpnea occurs • Occurs only in pathological conditions affect CNS –such as meningitis Seen in : Increased intra cranial pressure Morphine poisoning Damage to brain stem Cyanosis • When the concentration of reduced haemoglobin of blood in capillaries is greater than 5gms/dl dusky bluish dis coloration appears known as cyanosis. • Depends on 1. total amount of haemoglobin 2. degree of Hb unsaturation 3. state of capillary circulation Sites of cyanosis • Nail beds • mucus membranes • earlobes • lips • tip of nose • tips of fingers • tips of toes Types of cyanosis
1 central cyanosis 2. Peripheral cyanosis 3. Cyanosis due to abnormal pigments Central cyanosis Mainly due to hypoxic hypoxia, causing arterial unsaturation Seen in : • Congenital heart disease • AV admixture • Lung disease • High altitude • Arterial blood contains more reduced Hb because of the above causes.
• In central cyanosis skin & mucus membranes
develop cyanosis.
• Can be reduced by breathing pure O2.
Peripheral cyanosis • Commonly seen in stagnant hypoxia.
• Occurs due to slowing of blood which allows for
more time for removal of O2 by tissues.
• Seen in cardiac failure
shock cold environment peripheral vascular disease polycythaemia vera Peripheral cyanosis • Skin becomes cyanotic. • Does not respond to O2. Central cyanosis Peripheral cyanosis
1. Definition Due to hypoxic hypoxia Due to stagnant hypoxia
2. Causes All causes that produce All causes that produce
hypoxic hypoxia stagnant hypoxia
3. Characterisstic features Extremities are warm Extremities are cold
