HYPOXIA

Definition: Lack of oxygen at tissue levels.

Types of hypoxia:

1. HYPOXIC
2. ANEMIC
3. STAGNANT
4. HISTOTOXIC

POINTS TO REMEMBER:

1. Hypoxic hypoxia is the most common cause of hypoxia.

2. Peripheral chemoreceptors are stimulated by all types of hypoxia
except histotoxic hypoxia.

HYPOXIC HYPOXIA

Characterized by
1. Low arterial pO2.
2. Low arterial % O2 saturation of Hb.
3. Amount of Hb is normal.
4. Rate of blood flow is normal.

Causes:

1. High altitude: low pO2 IN inspired air

2. Decreased alveolar ventilation:
3. Gas exchange failure.
1) airway obstruction.
2) Respiratory centre pO2 by
drugs.
3) Weakness of respiratory muscles.
1) All factors altering ventilation
Perfusion ratio.(V/P ratio)

4. Venous arterial shunt. (Congenital heart disease.).

PATHOPHYSIOLOGY:

HYPOXIC HYPOXIA
↓
RESPIRATORY CENTRE
↓
HYPERVENTILATION
↓
DECREASED pCO2
↓
O2 HB curve shifts to left
↓
Less release of O2 from Hb.
↓
Tissue hypoxia.

ANAEMIC HYPOXIA

CHARACTERISTIC FEATURES:

1. Arterial pO2 is normal.

2. Arterial O2 content is decreased
3. Hb is reduced.
4. Arterial % O2 saturation of Hb decreased
5. Blood flow is normal.

CAUSES:

1. Anemia.
2. Bleeding
3. Methemoglobinemia.
4. Presence of carboxy hemoglobin.
STAGNANT HYPOXIA

DEFINITION: Blood flow to the tissue is low leading to decreased O2

delivery to tissues.

Characteristic features:
1. Blood flow to the tissues is decreased
2. Normal arterial O2 content.
3. Normal arterial PO2.
4. Normal arterial % O2 saturation of Hb.
5. Normal Hb.

Causes:

1. Circulatory failure
2. Bleeding
3. Heart failure.

HISTOTOXIC HYPOXIA

DEFINITION: Oxygen delivery to the tissues is normal but due to action of

toxic agents, tissues cannot make use of O2 delivered to them.

Characteristic features:

1. Normal arterial pO2.

2. Normal arterial % O2 SATURATION OF Hb.
3. Normal Hb.
4. BLOOD FLOW IS NORMAL.
5. Hb content is normal.

Causes:
1. Toxic agents: cyanide poisoning .
 Hypoxic Stagnant Anemic Histotoxic hypoxia.
hypoxia hypoxia. hypoxia
Characteristic
features
1.Hb Normal Normal Decreased Normal
2.Arterial decreases normal normal normal
PO2 normal decreased normal normal
3. Blood flow
to tissues.
Causes Low PO2 in Circulatory Anemia Cyanide poisoning
inspired air. collapse. Bleeding
Decreased Bleeding Methemoglob
pulmonary Heart failure inemia
ventilation. Presence of
Altered V/P carboxy
Ratio. hemoglobin.
Arterial O2 Decreases. normal Significantly normal
content reduced.
Arterial PO2 Decreased Normal Normal Normal
Arterial %O2 Decreased Normal Decreased Normal
saturation of
Hb