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Hypoxemia

Hypoxemia, or low blood oxygen, occurs when there is not enough oxygen circulating in the blood to tissues and cells. It can be caused by respiratory disorders that limit oxygen intake or transfer, such as COPD, pneumonia, or pulmonary embolism. Symptoms range from headaches with mild hypoxemia to cyanosis, irregular breathing, and loss of consciousness in more severe cases. Treatment involves increasing oxygen intake through supplemental oxygen, mechanical ventilation if needed, and addressing any underlying causes.

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Mark Angelo Chan
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151 views3 pages

Hypoxemia

Hypoxemia, or low blood oxygen, occurs when there is not enough oxygen circulating in the blood to tissues and cells. It can be caused by respiratory disorders that limit oxygen intake or transfer, such as COPD, pneumonia, or pulmonary embolism. Symptoms range from headaches with mild hypoxemia to cyanosis, irregular breathing, and loss of consciousness in more severe cases. Treatment involves increasing oxygen intake through supplemental oxygen, mechanical ventilation if needed, and addressing any underlying causes.

Uploaded by

Mark Angelo Chan
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd
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Hypoxemia

Hypoxemia, or low blood oxygen, describes a lower than normal level of oxygen in your blood.
In order to function properly, your body needs a constant level of oxygen circulating in the blood
to cells and tissues. When this level of oxygen falls below a certain amount, hypoxemia occurs
and you may experience shortness of breath.

Your doctor determines whether you have hypoxemia by measuring your blood oxygen level —
the amount of oxygen traveling in your arteries. Your blood oxygen can be measured by testing a
sample of blood from an artery.

An approximate blood oxygen level can also be determined using a pulse oximeter — a small
device that clips on your finger. Though the pulse oximeter actually measures the saturation of
oxygen in your blood, the results are often used as an estimate of blood oxygen levels. Normal
pulse oximeter readings range from 95 to 100 percent, under most circumstances. Values under
90 percent are considered low.

Causes

• Airway obstruction
• Anemia
• ARDS (acute respiratory distress syndrome)
• Certain medications, such as narcotics and anesthetics, which depress breathing
• Congenital heart disease — heart defects that are present at birth
• COPD (chronic obstructive pulmonary disease)
• Emphysema
• High altitudes
• Interstitial lung disease
• Pneumonia
• Pneumothorax
• Pulmonary edema
• Pulmonary embolism
• Pulmonary fibrosis
• Shock
• Sleep apnea
Causes of Hypoxemia

Hypoxemia is usually triggered off by respiratory disorders. Additionally, hypoxemia may also
be caused as a result of one or a combination of the following:

1. Hypoventilation: This refers to a condition when the oxygen (PaO2) content is the blood
decreases and a marked increase in the levels of carbon dioxide is observed. This lowered
PaO2 content can cause hypoxemia.
2. Low Inspired Oxygen: The FiO2 content in the blood is called as the fraction of inspired
oxygen in the blood. A decrease in this fraction of inspired oxygen may cause
hypoxemia.
3. Left to right shunt: This is another cause of hypoxemia. A left-to-right shunt is a
condition when there is a transfer of blood from the left side of the heart to its right side.
This may occur as a result of a hole in the following walls: the arterial walls, the wall
separating the two upper chambers (left and right atrium) or the wall separating the two
lower chambers (left and right ventricles) of the heart.
4. Ventilation-Perfusion mismatch: This is a condition in which an imbalance between the
volume of gas expired by the alveoli (alveolar ventilation) and the pulmonary capillary
blood flow is seen. This mismatch may cause hypoxemia.
5. Diffusion Impairment: In this condition, a marked reduction is seen in the oxygen
movement from the alveoli to capillaries. This restricted movement may trigger
hypoxemia.

Symptoms of Hypoxemia

The symptoms of hypoxemia depend on the severity i.e. the amount by which the partial pressure
has reduced.

1. Symptoms of mild hypoxemia:


o Restlessness
o Anxiety
o Disorientation, confusion, lassitude and listlessness
o Headaches
2. Symptoms of acute hypoxemia:
o Cyanosis (Skin appearing bluish due to insufficient oxygen)
o Cheyne-Stokes respiration (irregular pattern of breathing)
o Increased blood pressure
o Apnea (temporary cessation of breathing)
o Tachycardia (increased rate of heartbeats, more than 100 per min)
o Hypotension (abnormally low blood pressure, below 100 diastolic and 40 systolic.
Here, as an effect of an initial increase in cardiac output and rapid decrease later.)
o Ventricular fibrillation (irregular and uncoordinated contractions of the ventricles)
o Asystole (severe form of cardiac arrest, heart stops beating)
o Polycythemia (abnormal increase in RBCs. The bone marrow may be stimulated
to produce excessive RBCs in case of patients suffering from chronic hypoxemia)
o Coma
Nursing Mangement for Hypoxemia

1. Prone Positioning
The prone position refers to lying flat on the ground, with your face downwards. The prone
position is known to increase oxygenation. It can be used as a treatment for mild hypoxemia. The
effectiveness of prone positioning as a treatment of acute respiratory disorders is still under
suspect.

2. Mechanical Ventilation
Mechanical ventilation is a mechanism by which it is possible to aid or substitute spontaneous
breathing mechanically. Continuous Positive Airway Pressure (CPAP) is a device that provides
mechanical ventilation. It is an effective way of treating severe hypoxemia. This is a device that
forces a steady stream of air into the nasal passage. This flow, which is set at a pressure that can
overcome obstructions, prevents the airway from closing. The pressure to be maintained, should
be determined through careful observation.

3. Supplemental Oxygen Therapy (Oxygen therapy)


This form of treatment for hypoxemia includes administering oxygen to the patient, using
oxygen concentrators, cylinders or tanks. However, it is crucial that the precise levels of oxygen
in accurate amounts, be administered. Special care needs to be taken during supplemental
oxygen therapy for infants. Supplemental oxygen therapy and CPAP are usually prescribed
together as a treatment for hypoxemia. This is particularly efficient for treatment of hypoxemia
caused due to hypoventilation.

4. Transfusion of packed RBCs


Packed red blood cells refers to the concentrate of red blood cells obtained after the removal of
plasma in the blood. Packed red blood cells can be transfused as a treatment to patients suffering
from hypoxemia. This is known to increase the oxygen-carrying capacity of the blood. Sufficient
care should be taken during the blood transfusion to avoid infections. This form of treatment
cannot be used in case of patients who develop polycythemia (which is characterized by
abnormally high RBC count) as a result of chronic hypoxemia.

5. Increasing inspired oxygen


This form of treatment is an effective one for hypoxemia developed as a result of hypoventilation
or due to the reduction in inspired oxygen.

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