Hypoxia: Name: Abdalaziz Mostafa No: 1176

Hypoxia
Name: Abdalaziz Mostafa

mohamed Ahmed
No: 1176
Intro
Oxygen (O2) is an important chemical element

that represents approximately 21 % of the
Earth’s atmosphere. Until the end of the 1800s,
science has known little about the effects of
O2 depletion in the body. This prompted
researchers of the late nineteenth century to
investigate the physiological effects of high
altitude. In 1878, French physiologist Paul Bert
provided the first scientific evidence that the
lack of O2 (hypoxia) caused an incomplete
saturation of the blood leading to “undue
hyperpnea with exercise, nausea, headaches,
and great depression”. Since that time, research
and clinical observations have demonstrated
that hypoxia, whether acute or chronic, causes
certain predictable physiologic responses. These
occur irrespective of whether hypoxia is induced
by a pathological disease or by the environment,
such as by exposure to high altitude.
Types of Hypoxia
 Hypoxic Hypoxia
 Stagnant Hypoxia
 Hypemic Hypoxia
 Histoxic Hypoxia
Hypoxic Hypoxia
This is the most common form of hypoxia
encountered in aviation and occurs at the lung
level. This type of hypoxia is commonly called
altitude hypoxia. Pilots may experience hypoxic
hypoxia when flying at altitude in an
unpressurized aircraft. With increasing altitude,
the molecules of oxygen in ambient air get
farther apart and exert less pressure per square
inch. The percentage of oxygen does not change
as we ascend; however, the partial pressure of
oxygen in ambient air decreases as we go to
altitude. In other words, with increasing
altitude, the partial pressure of oxygen gets
lower and the lungs cannot effectively transfer
oxygen from the ambient air to the blood to be
carried to all tissues in the body
Stagnant Hypoxia
This type of hypoxia occurs at the circulatory
level. If the blood flow is compromised for any
reason, then sufficient oxygen cannot get to the
body tissues. To the pilot, this means, that even
though there is an adequate supply of oxygen to
breathe, it is not getting to the cells of the body
tissues to support their metabolism. Decreased
blood flow can result from the heart failing to
pump effectively, arterial constriction pooling of
the blood such as occurs during neurologic
shock or from enlarged veins in the lower
extremities. Stagnant hypoxia also occurs when
the body is exposed to cold temperatures
because the blood flow is decreased to the
extremities. This may happen following a rapid
decompression during flight or while operating
an aircraft in cold weather conditions without
cabin heating.
Hypemic Hypoxia
This type of hypoxia is caused by the reduced
ability of the blood to carry oxygen. To the pilot,
this means that, even though there is an
adequate supply of oxygen to breathe, the
blood's capacity to carry the oxygen to the cells
has been impaired. There are a variety of reasons
for this to happen. Anemia, hemorrhage,
hemoglobin abnormalities, sulfa drugs, nitrites,
and carbon monoxide interfere with the ability
of the blood to carry oxygen, reducing the
amount of oxygen the blood can carry to the
cells. The most common cause for hypemic
hypoxia in aviation is when carbon monoxide is
inhaled because of aircraft heater malfunctions,
engine manifold leaks, or cockpit contamination
with exhaust from other aircraft. Hemoglobin
bonds with carbon monoxide 200 times more
readily than it bonds with oxygen.
Histotoxic Hypoxia
This type of hypoxia happens at the cell level.
This means that the cell expecting and needing
the oxygen is impaired and cannot use the
oxygen to support metabolism. To the pilot, this
means that even though there is an adequate
supply of oxygen to breathe and that oxygen is
being circulated by the blood, the cells are
unable to accept or use the oxygen. Alcohol,
narcotics, and cyanide are three primary factors
that can cause histoxic hypoxia. Cyanide is one
of the byproducts during the combustion of
plastics.
Signs and symptoms

 Changes in the color of the skin, ranging
from blue to cherry red
 Confusion
 Cough
 Fast heart rate
 Rapid breathing
 Shortness of breath
 Slow heart rate
 Sweating
Diagnosis
In general, an individual patient’s
hypoxemia is usually diagnosed by oxygen
monitors placed on fingers or ears (pulse
oximeter) and/or by determining the
oxygen level in a blood gas sample (a
sample of blood taken from an artery).
Normal readings are about 94% to 99%
oxygen saturation levels; generally, oxygen
is supplied if the level is about 92% or
below.
Other tests may be ordered to determine if
other potential problems such as carbon
monoxide poisoning are responsible for the
hypoxia.
Pulmonary function tests may also be
ordered along with other studies to help
determine the cause of unexplained low
oxygen saturation.
Factors Influencing
Tolerance to Hypoxia
We can never predict definitely when, where or
how hypoxic reactions will occur.
But factors are determined and are:
 Rate of ascent
 Time spent at altitude
 Physical activity at altitude
 Fatigue
 Self-imposed stress
 Extreme ambient temperature
 Individual physiological fitness
Scientific causes
The main cause is the decrease O2 in
atmospheric air. Other causes include:
 Lung diseases as pneumonia, edema,
bronchial asthma and emphysema
 Heart diseases as left sided heart failure,
congenital heart disease as known as
arterial septal defect
 Anemia
 CO poisoning as mentioned
 Hemorrhage and Heart failure
 Obstruction of blood vessel in certain area
 Cyanid poisoning inhibits cytochrome
oxidase which is required in cellular
respiration
 Alcohol and narcotics inhibit
dehydrogenase which is required in
cellular respiration
 Acute respiratory distress syndrome
 A blood clot in the lung (pulmonary
embolism)
 A collapsed lung
 Scarring in the lungs (pulmonary fibrosis)
Complications
We should take in consideration that hypoxic
hypoxia and stagnant hypoxia may lead to
cyanosis. Other complications include:
 Depression and other mood and mental
disorders
 Confusion
 High blood pressure (hypertension)
 Pulmonary hypertension
 Acute respiratory failure
 Secondary polycythemia, which is an
abnormal increase in the number of re
blood cells (RBCs)
 When lungs retain too much carbon dioxide
due to breathing difficulties, Hypercapnia
occurs. When you can’t breathe in, it’s likely
you won’t be able to breathe out as you
should. This may elevate your carbon
dioxide levels in your bloodstream, which
can be deadly.
Treatment
Treatment for hypoxia aims to raise the levels of

oxygen in the blood. Doctors can use
medications to treat underlying conditions that
cause hypoxia. These medications are often
given through an inhaler that enables you to
breathe the medicine into your lungs.
In more severe cases, your doctor may prescribe
oxygen therapy. People typically receive extra
oxygen through a device called a cannula (tube)
that is clipped to the outside of the nose, or
through a breathing mask. The location and
amount of time people receive oxygen therapy is
based on individual needs. You may receive
oxygen at home, with a portable machine while
you travel, or in the hospital.
Happy Hypoxia
A phenomenon that is noticed among covid-19
patients that suffer from hypoxia. Some COVID-
19 patients with extraordinarily low blood-
oxygen levels have generally described
themselves as comfortable. patients can be
breathing comfortably with normal carbon
dioxide levels but have oxygen saturation levels
in the 70s, 60s, 50s or even lower. Some doctors
mentioned that this condition could be deadly.
They warned against swooping in to inflate
lungs with ventilators or high-pressure oxygen
when patients seem comfortable. They also
mentioned that those measures could harm
lungs that are inflating on their own but may be
needed if patients are not helped by non-
invasive treatment. The phenomenon has also
prompted a debate on how to treat coronavirus
patients.
References
 Hypoxia: Introduction of Mechanisms
and Consequences By Michael John
Decker and Juliana Cini Perry
 Medscape: "Hypoventilation
syndromes."
 Pittman, R. Oxygen Transport in
Normal and Pathological States: Defects
and Compensations.
 Samuel, J. "Hypoxemia and Hypoxia."
 Sarkar M, et al. (2017). Mechanisms of
hypoxemia
 Medscape. Oxygen Therapy in Critical
Illness
 Patel, N. D. "Oxygen Toxicity." JIACM
2003
 Science magazine: The mystery of the
pandemic's ‘happy hypoxia’
 American Thoracic Society. Oxygen
Therapy.

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Hypoxia

Name: Abdalaziz Mostafa

Oxygen (O2) is an important chemical element

Signs and symptoms

Treatment for hypoxia aims to raise the levels of

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