Hypoxemia is a term for decreased oxygen levels in the blood. Several lung diseases can result in hypoxemia.
What is hypoxemia?
In hypoxemia, the oxygen level in the arterial blood is decreased. Often, the term hypoxemia is used synonymously with the term hypoxia. However, hypoxia actually refers to the deficient supply of oxygen to organs and tissues. Normally, arterial blood is rich in oxygen. The normal value depends on gender and age. In women, the physiological oxygen content in arterial blood is 18.6 percent by volume; in men, it should not fall below 20.4 percent by volume. The oxygen content in the blood is calculated with the help of various auxiliary parameters. Thus, on the one hand, the oxygen saturation of hemoglobin in arterial blood (SaO2) and, on the other hand, the hemoglobin concentration in arterial blood are required. Hemoglobin concentration is expressed in grams per deciliter. The oxygen partial pressure also plays a role in calculating the oxygen content in the arterial blood. An oxygen level below 12 percent by volume is in the critical range. Hypoxemia causes the skin to turn gray or bluish. Shortness of breath, muscle weakness, and clouding of consciousness are possible symptoms.
Causes
Hypoxemia may be due to a variety of causes. For example, a reduced supply of oxygen in the ambient air leads to a lack of oxygen in the blood. Thin high-altitude air (above 3000 meters) contains significantly less oxygen. People who live permanently at this altitude have more red blood cells to compensate for this lack of oxygen in the air. This is also referred to as polyglobulia. Blood deficiency also leads to hypoxemia. Oxygen is transported with the help of hemoglobin. If there is a deficiency of hemoglobin, not as much oxygen can be bound. Anemia, a condition called anemia, can have various causes. These include iron deficiency, chronic bleeding, tumor disease or vitamin B12 deficiency. More commonly, however, hypoxemia is caused by lung disease. Impaired gas diffusion within the lungs results in decreased uptake of oxygen. Gas diffusion may be disturbed by pulmonary edema, for example. Pulmonary edema is an accumulation of fluid within the lungs. The edema can be caused by cardiac insufficiencies, cardiac arrhythmias, valvular defects, medications, toxic substances, and by viruses, bacteria, or fungi. Another cause of hypoxemia is cancer. In particular, small cell lung cancer and bronchial carcinoma limit the function of the lungs. Smokers are most commonly affected by these diseases. The same is true for chronic obstructive pulmonary disease (COPD). COPD can develop into emphysema. In this case, the small structures of the lungs are overinflated, so that gas exchange can no longer take place in the affected areas. The “blue bloater” type of emphysema is characterized by hypoxemia. Hypoxemia can also result from a mismatch between lung blood flow and lung ventilation. An example of this is pulmonary embolism. Here, a thrombus becomes lodged in the vessels of the lung. A cardiac shunt can also result in hypoxemia. A shunt is a connection between the normally separate parts of the systemic and pulmonary circulations. Oxygen-depleted venous blood enters the arterial vessels through the shunt.
Symptoms, complaints, and signs
The symptoms of hypoxemia are often rather uncharacteristic and appear harmless at first glance. Those affected are constantly tired and dull. They complain of fatigue and poor concentration. In more advanced stages, shortness of breath (dyspnea) develops on exertion. To compensate for the lack of oxygen in the blood, the heart beats faster. An increased pulse and palpitations are the result. In rare cases, cardiac arrhythmias may also develop. In severe cases, hypoxemia impairs brain function. Patients suffer from dizziness or fainting. Clouding of consciousness and even coma are possible. The lack of oxygen makes itself felt in the heart through angina pectoris pain and a feeling of tightness in the heart area.
Diagnosis and course of the disease
The first clues to hypoxemia are provided by the clinical picture and the medical history.Long-term tobacco use, cough with or without expectoration, difficulty breathing on exertion, and a bluish discoloration of the fingers or lips can be taken as evidence of hypoxemia. If hypoxemia is suspected, blood carbon dioxide and oxygen levels are measured in a blood gas analysis. Blood gas analysis requires arterial whole blood or capillary blood from the fingertip. The analysis is performed by machine and takes only a few minutes. Blood gas analysis can therefore usually be performed as an immediate diagnostic test. If the suspected diagnosis of hypoxemia is confirmed, the cause must be investigated. Further blood tests as well as examinations with imaging techniques can lead to the cause. X-ray, magnetic resonance imaging, or computed tomography are conceivable examination options.
Complications
Usually, hypoxemia occurs whenever the patient suffers from pulmonary or respiratory symptoms. In this case, the low oxygen level in the blood can have a very negative effect on the patient’s health. The result is severe fatigue and exhaustion. It is not possible to compensate for the fatigue with sleep. In the case of respiratory diseases, there is also severe shortness of breath, which in many cases leads to a panic attack. The affected person can lose consciousness and possibly injure himself in a fall. Dizziness and nausea occur, and the patient is also no longer able to concentrate. The quality of life is severely limited and reduced by hypoxemia. Many activities from the usual everyday life are also no longer possible. Hypoxemia is always treated causally, although it does not always result in a positive course of the disease. Complications can occur if the disease is carcinoma or cardiac insufficiency. In these cases, it is not uncommon for the patient to die.
When should you go to the doctor?
Hypoxemia is usually manifested by rather uncharacteristic symptoms. A physician should be consulted when symptoms such as unusually severe fatigue and lassitude are noticed, possibly associated with an elevated pulse and palpitations. If cardiac arrhythmias are suspected, it is best to consult a physician immediately. Dizziness and a feeling of tightness in the heart area are also clear warning signs that require examination by a physician. If other symptoms develop, the doctor must be consulted the same day. People suffering from an eating disorder or a lung disease are particularly susceptible to the development of hypoxemia. The symptoms mentioned should definitely be clarified in these cases. Children are best taken immediately to the pediatrician in charge. Specialists in pulmonary diseases as well as nutritional physicians may also be consulted. In the event of a medical emergency, the emergency number should be dialed. In any case, diagnosed hypoxemia must be closely monitored and treated by a physician.
Treatment and therapy
Treatment of hypoxemia depends on the cause. If the hypoxemia is due to pulmonary edema, the causative disease must also be treated. Heart failure, for example, is treated with heart-strengthening drugs. Heart valve defects are treated surgically. If cancer is the cause of the oxygen deficiency, chemotherapy is usually administered. Surgery or radiation therapy may also be used to treat bronchial carcinoma. In the case of pulmonary embolism, a so-called lysis therapy is performed. The aim is to dissolve the thrombus that is blocking the pulmonary vessels with medication. In severe cases, additional oxygen administration and reperfusion therapy are required. Surgical intervention may also be indicated.
Prevention
Smoking is the main risk factor for lung diseases such as COPD or lung cancer. Cigarettes and other tobacco products should therefore be strictly avoided. However, hypoxemia can, of course, develop in nonsmokers as well, so reliable prevention is not possible.
Follow-up
Hypoxemia can be controlled by close medical monitoring following medical therapy. Depending on the culprit for the condition, heart-strengthening medications may be used.In addition to drug support in the course of follow-up treatment, patients can actively participate in their own health improvement. In principle, giving up nicotine has a positive effect on the development. However, non-smokers can also suffer from the disease. In the aftercare phase, it is important for affected individuals to get sufficient rest. With sufficient sleep at night, patients gradually feel better. Also helpful is a healthy, whole-food diet. In combination with light, sporting activities, fitness increases and the immune system becomes stronger. Lowering stress levels can also have a positive effect on quality of life. Through targeted breathing exercises, sufferers train their muscles so that the body subsequently absorbs more oxygen. How effective these approaches are depends on the cause of the disease and the discipline of the patient. It may be possible to accompany follow-up care with homeopathic help. This is useful, for example, when pulmonary edema is present. For other cases, however, self-treatment is less suitable.
This is what you can do yourself
One can accompany the advised therapies with appropriate rest during the day and adequate sleep at night. A whole-food diet, a few low-impact, endurance sports activities, and a reduction in stress can improve quality of life. In general, breathing muscles can be strengthened and built up. Gymnastic breathing exercises are advised for this purpose. Correct breathing can be learned and enables better oxygen uptake by the blood. Smoking, however, should be reduced as much as possible, and preferably stopped altogether. Relief in dealing with the disease depends in on the cause. In the case of pulmonary edema, it is possible to work with a homeopath. However, if the pleural effusion is severe, self-treatment should be avoided. If the cause is heart failure and the sufferer is experiencing shortness of breath, it may be advisable to allow sufficient time for each task. Rest breaks are necessary and important. If the lack of oxygen is caused by a change in the spine, additional chiropractic care may provide relief. If the lack of oxygen accompanies tinnitus, it is useful to stimulate the blood circulation. Ginkgo is the plant of choice here. It is excellent for reducing ringing in the ears and achieving a higher quality of life.
