Hypoxia: Syafira Nurfitri 1501211054

HYPOXIA Syafira Nurfitri
1501211054
DEFINITION
Normoxia describes the state in which a physiologically adequate supply of oxygen to
the tissues, whether in quantity or molecular concentration, is available.
When the level of oxygen available is below that requirement, a state of hypoxia is
said to exist.
(Ernsting’s Aviation and Space Medicine, 5th Edition)
CLASSIFICATION
Hypoxic Hypoxia
Anaemic Hypoxia
Ischaemic (Stagnant) Hypoxia
Histotoxic Hypoxia
HYPOXIC HYPOXIA
The result of a reduction in the oxygen tension in the arterial blood, and hence, in the
capillary blood.
Aetiology:
1. Low oxygen tension of inspired gas associated with exposure to altitude (e.g.,
hypobaric hypoxia)
2. Hypoventilatory states (e.g., paralysis of respiratory musculature)
3. Impairment of gas exchange across the alveolar-capillary membrane (e.g.,
pulmonary edema)
4. Impairment of the circulation with right-to-left shunts
5. Ventilation-perfusion mismatches (e.g., emphysema, chronic bronchitis)
ANAEMIC HYPOXIA
The consequence of a reduction in the oxygen-carrying capacity of the blood.
Aetiology:
1. Reduced erythrocyte count (e.g., haemorrhage, increased red cell destruction,
decreased red cell production)
2. Reduced Hb concentration (e.g., hypochromic anaemia)
3. Synthesis of abnormal Hb (e.g., sickle-cell anemia)
4. Reduced oxygen-binding capability (e.g., CO inhalation)
5. Chemical alteration of Hb (e.g., methaemoglobinaemia)
ISCHAEMIC (STAGNANT)
HYPOXIA
The consequence of a reduction in blood flow through the tissues.
Aetiology:
1. Local arteriolar constriction (e.g., exposure of digits to cold)
2. Obstruction of arterial supply by disease or trauma
3. General circulatory failure (e.g., cardiac failure)
4. The fall in cardiac output and BP associated with exposure to high sustained
accelerations.
HISTOTOXIC HYPOXIA
The result of an interference with the ability of the tissues to utilize a normal oxygen
supply for oxidative processes.
Example: cyanide poisoning  the action of cytochrome oxidase of the
mitochondria is completely blocked
The hypoxic hypoxia is by far the most common form of oxygen deficiency that
occurs in aviation and results from a reduction in the oxygen tension in inspired gas.
ACUTE HYPOBARIC
HYPOXIA: HYPOXIA IN
FLIGHT
AETIOLOGY
The principal causes of hypoxia in flight are:
Ascent to altitude without supplementary oxygen.
Failure of personal breathing equipment to supply oxygen at an adequate
concentration and/or pressure.
Decompression of the pressure cabin at high altitude.
CLINICAL FEATURES
The clinical picture of acute hypobaric hypoxia is a combination of the cardiorespiratory responses
and neurological effects.
The symptoms and signs are extremely variable  variation between individuals.
Factors:
1. Intensity of hypoxia: maximum altitude, rate of ascent and duration of exposure to altitude.
2. Physical activity: exercise exacerbates the features of hypoxia.
3. Ambient temperature: a cold environment will reduce tolerance to hypoxia, in part at least, by
increasing metabolic workload.
4. Intercurrent illness: similarly, the additional metabolic load imposed by ill health will increase
susceptibility to hypoxia.
5. Use of certain drugs, including alcohol.
Personality change. Dizziness.
Lack of insight. Light-headedness.
Loss of judgement. Feelings of unreality.
Loss of self-criticism. Feelings of apprehension.
Euphoria. Neuromuscular irritability.
Loss of memory. Paraesthesia of face and extremities.
Mental incoordination. Carpopedal spasm.
Muscular incoordination. Semi-consciousness.
Sensory loss. Unconsciousness.
Cyanosis. Death.
MANAGEMENT
Oxygen therapy
NOTES: Oxygen therapy is of great value in certain types oh hypoxia, but of little or
no benefit in others.
In aviation, consideration must be given to the potential interaction of various forms
of hypoxia, and an awareness of the limitations of oxygen therapy is required.
REFERENCES
Gradwell, David P., David J. Rainford. 2016. Ernsting’s Aviation and Space
Medicine 5th Edition. New York: CRC Press.

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HYPOXIA Syafira Nurfitri

Ischaemic (Stagnant) Hypoxia

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