Is your body lacking oxygen? Let's learn about hypoxia.

Do you sometimes feel short of breath, dizzy, or disoriented? These could be due to hypoxia, a condition in which your body's tissues don't get enough oxygen. Since this can be a bit serious, let's talk about it in a simple, easy-to-understand way. Don't panic, the most important thing is to be aware.

What is hypoxia? Simply put...

Okay, let's first understand what hypoxia is. Simply put, it's when your body's tissues don't get enough oxygen. When we breathe, oxygen goes into the lungs. From there, it's absorbed into the blood through tiny air sacs in the lungs (called alveoli) and into the very fine blood vessels (called capillaries) that run nearby. This oxygen-rich blood then travels throughout the body and delivers oxygen to other tissues.

You can think of oxygen as a billion passengers arriving at an airport (i.e., your lungs). They are picked up from there and transported on a highway (i.e., your bloodstream) to their destination (i.e., your body's tissues). When the oxygen gets to its proper place, it makes way for another passenger , carbon dioxide . This carbon dioxide is a waste product. It goes back into your lungs and leaves your body when you exhale.

So, if you don't get enough oxygen somewhere along the way, hypoxia can occur. This requires both airflow and blood flow . That's why people with lung disease and heart disease are at increased risk of developing hypoxia. We also call someone who is suffering from hypoxia "hypoxic."

What is the difference between Hypoxia and Hypoxemia?

You may have heard these two words – hypoxia and hypoxemia – used interchangeably. But they are not really the same. The names are similar, which can be confusing, because both conditions involve a lack of oxygen, but in different parts of the body.

• Hypoxia is a decrease in oxygen in your body's tissues .
• Hypoxemia is a decrease in oxygen in your blood .

Hypoxia often occurs as a result of hypoxemia, but this is not always the case. A person can be hypoxic without being hypoxemic, and vice versa. Do you understand?

Who is at higher risk of developing hypoxia?

Any condition that reduces the amount of oxygen in your blood, or anything that restricts blood flow, can cause hypoxia. In particular,

• COPD (Chronic Obstructive Pulmonary Disease)
• Emphysema
• Asthma

People with heart or lung disease are at higher risk of developing hypoxia.

Also, some infections such as pneumonia, influenza, and COVID-19 can increase this risk.

What are the effects and symptoms of hypoxia?

Oxygen is essential for our body's cells to produce energy and for our organs and tissues to function properly. Although some tissues can adapt to temporary decreases in oxygen levels, prolonged hypoxia can damage organs. Damage to the brain and heart in particular is dangerous and can even lead to death. We call this lack of oxygen to the brain cerebral hypoxia .

Symptoms of hypoxia can vary from person to person. It depends on the severity of the condition, the underlying cause, and which parts of the body are affected. When your oxygen levels drop, you may feel like you can't breathe or think.

Here are some common symptoms of hypoxia:

• A restless, restless disposition.
• Headache.
• Confusion of mind, inability to organize one's thoughts.
• Constant fear and anxiety.
• Fast heartbeat (doctors call this tachycardia).
• Rapid breathing (this is called tachypnea).
• Difficulty breathing or shortness of breath (this is called dyspnea).

As hypoxia becomes more severe, other symptoms may appear:

• Slow heart rate (bradycardia).
• Excessive agitation.
• Blue discoloration of the skin, lips, and fingernails (called cyanosis). This is a very dangerous sign.

Important: If you or someone you know has these symptoms, it is very important to seek medical advice immediately.

What are the main causes of hypoxia?

Hypoxia is often caused by an underlying medical condition that affects blood circulation or breathing. Some conditions that can lead to hypoxia include:

• Anemia - lack of blood in the body.
• Asthma.
• Bronchitis - Inflammation of the bronchial tubes.
• COPD (Chronic Obstructive Pulmonary Disease) - A long-term lung disease.
• Congenital heart defects.
• Some conditions of heart failure (Congestive heart failure).
• Emphysema - damage to the air sacs in the lungs.
• Pneumonia - Can be caused by bacteria or viruses.
• Air filling the space around the lungs or lung collapse (Pneumothorax).
• Pulmonary edema.
• Pulmonary embolism.
• Pulmonary hypertension.
• Pulmonary fibrosis - scarring of the lungs.
• Sleep apnea.

Don't be alarmed by this list. Not everyone who has one of these will develop hypoxia, but the risk is there.

There are 4 main types of hypoxia:

In order for the cells in our tissues to receive oxygen properly, several things need to be right:

1. The air we breathe must contain enough oxygen.

2. Healthy lung function is necessary to carry oxygen to our air sacs (`alveoli`).

3. You need a healthy heart and circulatory system to carry oxygen-rich blood to the tissues.

4. There must be enough red blood cells to carry oxygen.

5. Cells in tissues must have the ability to use oxygen.

A lack of oxygen in any of these areas can cause one of four types of hypoxia.

1. Hypoxemic Hypoxia

This is the most common type of hypoxia . This is when there is a decrease in the amount of oxygen in the blood (called hypoxemia). This condition can be caused by lung and heart diseases, congenital heart defects, and some medications that slow breathing. Also, when you go to a high altitude area like Nuwara Eliya, the oxygen level in the air is low, which can lead to hypoxemia, which can lead to hypoxia.

2. Circulatory Hypoxia

This is also called stagnant hypoxia or ischemic hypoxia. What happens here is that your blood may have plenty of oxygen, but if your heart isn't pumping blood properly, or if a blood vessel is blocked somewhere, that oxygen isn't getting to your tissues. Congestive heart failure and blood clots increase the risk of this type of hypoxia.

3. Anemic Hypoxia

Now, some people say that they have low blood pressure, right? That means they don't have enough red blood cells. These red blood cells are what carry oxygen from the lungs to the rest of the body. So, if you don't have enough red blood cells to carry oxygen, that is, if you have anemia, this type of hypoxia occurs. If the body doesn't produce enough red blood cells, or if the red blood cells that are produced are deformed, anemia can occur.

4. Histotoxic Hypoxia

This is a little different. Here, your lungs are getting enough oxygen, and your blood is getting it. But for some reason, the cells in the tissues can't use that oxygen properly. This is similar to what can happen when you ingest a poison like cyanide. Even though the cells are getting oxygen, they can't use it.

How is hypoxia diagnosed?

Your doctor will first examine you, listen to your heart and lungs. They may also check your skin, nails, and lips for blueness. In addition, they may order other tests to check your oxygen levels and find the underlying cause of hypoxia:

• Pulse Oximetry: This is a very simple, painless test. A small sensor is clipped to your finger. It measures the amount of oxygen in your blood. You've probably seen this many times.
• Arterial Blood Gas test (ABG): This involves taking a small amount of blood from an artery in your wrist, arm, or groin using a thin needle to check your oxygen levels.
• Pulmonary Function Test (PFT): This involves you breathing in and out through a mouthpiece connected to a machine. It measures how well your lungs are working.
• Imaging tests: Tests such as X-rays, CT scans, and V/Q scans take pictures of your internal organs. These can help determine the cause of hypoxia.
• Six-Minute Walk Test (6MWT): This test measures how far you can walk in a flat area for six minutes. This test can give you an idea of ​​your lung and heart function.

How is hypoxia treated?

Treatment for hypoxia depends on the underlying cause . It can be a one-time event or a chronic condition. Treatment options include:

• Medicines that open your airways, such as inhaled steroids, to treat asthma or other lung diseases.
• Medicines that reduce excess fluid in the lungs (called ``Diuretics'').
• Using a CPAP (Continuous Positive Airway Pressure) mask to treat sleep apnea.
• The use of BiPAP® (BiLevel Positive Airway Pressure) (often known by the brand name BiPAP®) for COPD and some sleep apnea conditions.
• Supplemental oxygen for chronic hypoxia. This involves attaching an oxygen machine, either through a mask or a tube, to your nose to increase the amount of oxygen that reaches your lungs and air sacs (alveoli).
• In cases of severe acute hypoxia, mechanical ventilation may be performed in a hospital.

How do I manage the symptoms of hypoxia?

If you feel unsteady on your feet, your heart rate or breathing is fast, or your nails, lips, or skin appear blue, you should definitely seek medical attention immediately . Do you know what? Hypoxia is a condition that needs to be treated immediately. If not, it can sometimes damage important organs in our body.

In long-term conditions like COPD, this hypoxia may persist, but the symptoms may not be as severe. In such cases, your doctor will tell you how to manage your condition and reduce the risk of low oxygen levels. Never ignore new symptoms. If you notice anything different, tell your doctor.

How to reduce the risk of hypoxia?

The best way to reduce your risk of hypoxia is to properly manage any underlying medical conditions that may be reducing your oxygen levels. If you have heart or lung disease, talk to your doctor about specific ways to reduce your risk.

Keep in mind that certain medications and situations such as traveling to high altitudes can increase the risk of hypoxia. Ask your doctor about special precautions you should take when traveling or changing medications.

How do I live with this situation?

Hypoxia usually requires immediate medical attention. Your doctor will explain to you the underlying cause and how to manage it going forward.

In some cases, hypoxia resolves when the underlying condition is treated, eliminating the need for supplemental oxygen. However, in some cases, chronic supplemental oxygen may be needed to prevent hypoxia and prevent tissue damage from low oxygen levels. Your doctor will discuss the options that are right for you.

How do I take care of myself?

If you have an underlying medical condition that caused or is likely to cause hypoxia, managing that condition is the best way to reduce the risk of it happening again.

• Don't ignore new symptoms. If you feel like something is wrong, trust your instincts and see your doctor or go to the Emergency Department (ETU) .
• Take care of yourself. If you have asthma, be aware of your triggers. Always carry a rescue inhaler with you, if prescribed by your doctor. Do breathing exercises as your doctor has prescribed.
• Avoid smoking and using tobacco products. If you smoke, quitting can improve your lung function and prevent further damage.
• Take any medication your doctor prescribes exactly.
• If you are traveling to high altitudes, make a plan. Even people without any underlying medical conditions can experience difficulty breathing at high altitudes. Understand how this will affect you and make a plan to adapt to the change. Also consider what to do if you need medical advice. Give yourself enough time to acclimatize, if necessary, and bring any extra equipment or medications you may need.

When should I go to the Emergency Department (ETU) ?

Hypoxia is a potentially life-threatening condition. If you have any symptoms of hypoxia, or if others notice a sudden change in your behavior or consciousness (confusion, agitation, altered consciousness), go to the Emergency Department (ETU) immediately. If you have an ongoing medical condition and your usual symptoms suddenly get worse, or if you develop new symptoms that you think may be hypoxia, go to the Emergency Department.

What questions should I ask my doctor?

If you or a loved one is diagnosed with hypoxia, here are some questions to ask your doctor:

• Doctor, is this hypoxia due to some other underlying disease?
• How can I manage my condition to reduce my risk of hypoxia?
• Has this caused any damage to my organs, or have there been other complications?
• Do I need to make any changes to my lifestyle to reduce the risk of hypoxia?
• Could changing my travel plans or medications increase my risk of hypoxia?

Finally, remember (Take-Home Message)

Hypoxia is a life-threatening condition, but it can be treated with prompt medical attention. If you have a heart or lung condition that puts you at risk for hypoxia, talk to your doctor about what symptoms to look out for and what to do if you think your oxygen levels are low.

Remember, you know your body best. So, if you have any symptoms that worry you, don't hesitate to call your doctor immediately or go to the nearest Emergency Department (ETU) . Stay healthy!

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