KLASIFIKASI HIPOKSIA

Pembimbing:
dr. Erniody, Sp.An KIC M.Kes

Penyusun:
Berlian Purnamasari Setiono - 406152036

KEPANITERAAN KLINIK ILMU ANESTESI

PERIODE 21 AGUSTUS 2017 – 23 SEPTEMBER 2017
RUMAH SAKIT HUSADA
FAKULTAS KEDOKTERAN UNIVERSITAS TARUMANAGARA
Definition

Hypoxia means "reduced oxygen" or "not enough

oxygen“. Most concern is with getting enough oxygen to
the brain. Any reduction in mental function while flying can
result in life-threatening errors.
Causes
Hypoxia can be caused by several factors including:

a) insufficient supply of oxygen,

b) inadequate transportation of oxygen, or
c) the inability of the body tissues to use oxygen.
TYPES OF HYPOXIA:
There are 4 types of hypoxia:
1. Hypoxic Hypoxia
2. Anemic Hypoxia
3. Stagnant / Ischemic Hypoxia
4. Histotoxic Hypoxia
HYPOXIC HYPOXIA:
Causes:
1. High altitude  decreased PO2 in atmospheric air.
2. Respiratory muscle paralysis.
3. Obstructive lung disease (COPD).
4. Restrictive lung disease (pulmonary fibrosis,
pneumothorax).
5. Depression of respiratory centre (disease/ drug).
Effect on arterial PO2:
• Decreased arterial partial pressure of oxygen. MCQ
• In other types of hypoxia, PO2 is normal.
Clinical features of Hypoxic Hypoxia:
• Due to decrease arterial PO2  Interstitial cells
in peritubular capillaries of kidney secrete
Erythropoietin  polycythemia
• Hypoxia  pulmonary V.C  Pulm. Hypertension
 Rt. Vent. Hypertrophy  Rt. Vent. Failure.

TREATMENT: O2 treatment is most effective in

this type of hypoxia.
ANEMIC HYPOXIA:
• Arterial PO2 is normal
but inadequate O2
+ + carrying capacity of
+
blood.
+ • Causes:
+ + 1. decrease in Hb conc.
+
+ + 2. abnormal Hb like met-
+
Hb or Hb-S
+ + 3. CO poisoning:
+ binding site of Hb for
oxygen is not
available
+
+
Treatment of CO Poisoning:
• Remove the subject from source of exposure.
• 100% oxygen therapy can help.
• Hyper-barric O2 can help (O2 with increased pressure =
2-3 atm)
Stagnant Hypoxia
Adequate
oxygen
Reduced
blood
flow
Blood Red blood cells
moving not replenishing
slowly tissue needs
fast enough
STAGNANT / ISCHEMIC HYPOXIA:
CAUSES:
• Decreased cardiac output / sluggish blood flow due to:
• heart failure,
• hemorrhage,
• circulatory shock and
• venous obstruction.
• EFFECTS:
• Blood remains in tissues for longer time, so tissue
extracts increased oxygen from blood  more AV
difference of oxygen concentration.
• So, PCO2 increases, it facilitates unloading of oxygen
from hemoglobin (shifts the oxy-hemoglobin association
dissociation curve to right).
 Histotoxic Hypoxia
Adequate Inability of the
oxygen
cell to accept
or use oxygen

Red blood cells

retain oxygen

Poisoned tissue
HISTOTOXIC HYPOXIA
DEFINITION: Inability of the tissues to utilize oxygen inspite of
normal arterial PO2 and oxygen carrying capacity.

CAUSES:
• Cyanide poisoning (it inhibits cytochrome oxidases  oxidative
process is inhibited).
• Narcotic overdosage (it inactivates the enzyme dehydrogenase
 inhibition of tissue oxygenation).
• Beri-beri (it is deficiency of thiamine co-enzyme which is
required for many oxidative reactions).
TREATMENT:
• Methylene blue or nitrites. These convert hemoglobin  met-
hemoglobin.
• Cyanide + met-hemoglobin  cyn-met-hemoglobin (non-toxic
compound).
THANK YOU