https://preview.redd.it/gdurdv3ojz181.png?width=2732&format=png&auto=webp&s=eb1be0da965899e59585d2c3d6ff78d88719c791
Consider this image.
- A1 and A2 are alveoli
- a1 and a2 are their respective capillaries.
Let's say a1 is completely blocked by an embolus (yellow drawing).
- That implies infinite resistance -> blood is redirected towards the other alveoli. So flow through a2 is increased.
- Now there's a lot more blood that needs gas exchange with A2. Given that blood in a2 doesn't spend a large amount of time with A2, it's safe to assume that gasses won't have a chance to equilibrate between A2 and a2. So, with euventilation, I'd expect hypercapnia and hypoxemia.
Now, let's say the patient is hyperventilating.
- Why does it seem like CO2 has a much easier time going across the A2-a2 interface than does O2—so much so that hyperventilation cause respiratory alkalosis?
- Why does PaO2 does not equilibrate with hyperventilation? The concept of hemoglobin "capping" doesn't make sense to me here. You have more blood going through a2. More blood = more hemoglobin per unit time. It seems like O2 just has a harder time dealing with diffusing issues. Is that the correct logic here?
- Lastly, supplemental oxygen does not work with right-left shunting, and I get that. But, I'm trying to see how supplemental oxygenation would work here. A greater O2 gradient -> faster O2 exchange. Is that the idea here? Is that that the "effective" O2 gradient is greater with O2 supplementation than with hyperventilation/
Thank you.
During the day i feel short of breath in general a lot of the time, and low energy. Will the cpap cure my day time hypoxemia?
So... I have had a sharp decline in my memory and ability to function on a daily basis. I thought and kinda wish now I was narcoleptic, but it seems it's the fact while I sleep my oxygen drops and I guess my body wakes me up to try and save itself. Sorry, I don't fully understand what word for word is happening. What I gather though, is the nocturnal hypoxemia that is causing me the most issue. I was told today I have COPD and my doctor said he thinks I should qualify for disability. I'm only 30. I submitted for SSI today cause my mom told me to. Her husband had cancer in his brain and had it removed, part of his brain. So she is familiar with the process. I see exercising helps with the lungs in keeping them as healthy as possible, however, I can't find anything about the nocturnal hypoxemia part. Can anything be done to help it? Is there anything I can do to get better sleep? I asked the doctor, but they leave me with. Take meds and enjoy what time I have left. I know the internet isn't going to solve the issue. Any advice is welcomed. Life expectancy? daily issues? I had a home sleep study, that is how I got the nocturnal hypoxemia diagnosis. I have a sleep study at the hospital on Friday. I'm not sure what needs to happen next. I seem physically fine for now. I can run, not like someone who has trained for it, but I am no couch potato either (not that I am saying there is anything wrong with that). Is it smart for me to do things like mowing a lawn, or be near smoke like at a BBQ. I ask because I don't have any immediate family around but my inlaws. The one thing I do when my FIL is cooking out, he does this all the time like every day, I sit outside with him cause no one else will. It's the one way I was able to bond with him despite my years of failing till now. It sounds stupid, but I am saddened that I won't be able to do this anymore. I am afraid how everyone else will respond when I don't want to go cut a yard or something. Just, what are things I should look out for? Also, my Doctor said it's not best for me to wear a face mask due to this. Is that true? Just with the COVID stuff, I don't want to make things worse by not taking care of myself when out and about. My mind is all over the place and I am not sure how to feel. Honestly, any information will help. If you read this, thank you for your time. Hopefully, you have better days ahead of you.
Which lecture does he talk about hypoxia/hypoxemia? He describes the respiratory process in a beautiful way that just really makes sense to me, and I'd love to review it.
EDIT: I don't think it's in the Resp, though it could be. I remember being surprised when he brought it up, so potentially cell injury or flow?
FYI, I listen to the lectures via Daddy Goljan Lectures playlist on Spotify (lol)
It seems like “refractory hypoxemia” is reserved for patients that are being given high levels of O2 for sustained periods, but what about someone, say, on a simple mask with an O2 of 62mmHg? Do we just say “mild hypoxemia on simple mask” or is there some better way to note this?
UWorld says that V/Q mismatch as seen in pulm embolism causes hypoxemia. This can be corrected by supplemental oxygen as it increases the alveolar partial pressure of O2.
But it also says that Hb in general becomes fully saturated with O2 easily so hyperventilation wont cause an increase in PaO2. So how can supplemental oxygen help in this case, when the Hb in the perfused areas is already saturated and cannot take in more O2?
I'm always confused when i get these. thank you <3
I’ve been using an oximeter for some of my breathing sessions lately. I consistently reach states of hypoxemia, in which my SpO2 drops well below the normal level- as low as 2%, although I have no idea if the levels are accurate when they get that low.
There’s mounting evidence that hypoxia in small doses is beneficial (hormesis) but little I can find about hypoxemia. And unfortunately an oximeter can only measure hypoxemia. There’s usually a connection between the two but not always.
Hypoxia almost certainly occurs during the breathing due to the low levels of CO2 in the blood causing O2 to remain bound to hemoglobin. Presumably the hypoxemia that occurs towards the end of the retention is this oxygen being released as CO2 levels build back up.
So my uneducated guess is that the level of hypoxemia you achieve is probably correlated to the hypoxia- the more the SpO2 drops, the more your organs were deprived of O2 through hypoxia.
What I’m wondering and hoping someone with medical training may be able to shine some light on is
- is it correct that hypoxemia in the WHM would correlate with hypoxia?
- would it be reasonable to assume that the degree of hypoxemia is an indicator of how well a session goes, assuming the benefits are partially due to hypoxia?
It would be nice to have some solid guidelines. I think we can all subjectively feel that some sessions seem better. But can we correlate this to numbers, determine what tweaks to the method improve these numbers and breathe accordingly?
Med student here trying to interpret some information correctly.
Is it safe to assume that, due to excessive hydrostatic pressure in the respiratory capillaries surrounding the alveoli, resulting in pulmonary edema, the cause would be hypoxemia (low levels of oxygen in the arterial blood)? And edema in the peripheral capillaries, due to excessive hydrostatic or insufficient oncotic pressure, would be a result of cellular hypoxia? I am trying to understand the difference between hypoxemia and hypoxia (cellular hypoxia). My understanding is that you can have sufficient o2 in arterial blood, but still have hypoxia as a result of edema in the peripheral capillaries, or poor peripheral perfusion. I understand that edema, causing interstitial outside of the capillary walls, disrupts perfusion because it affects the permeability of the capillary wall.
Also, my understanding is that a failure in the left side of the heart (left atrium or left ventricle) can cause pulmonary edema. Since pulmonary edema is caused by excessive hydrostatic pressure (if I am correct), what would be an example of what would cause this failure?
TIA
Can somebody explain difference btw hypoxemia ,hypoxia ,ischemia?
Really confused about this concept. I'm thinking maybe to compensate for respiratory alkalosis (kind of like how K+ sparing diuretics block aldosterone and inhibit H+ ATPase) but not sure and can't find the answer anywhere
???
Results came back and was diagnosed with “Mild obstructive apnea with hypoxemia without hypoventilation” ... What does this mean ? 4.1 AHI (17 F)
Why are the lungs able to blow off excess CO2 but not able to bring O2 back up?
