KLASIFIKASI HIPOKSIA

Hypoxaemia during anaesthesia

Causes of hypoxaemia occurring during anaesthesia can be divided into the following three categories: 1 Problems with O2 supply: This usually involves equipment failure resulting in the delivery of a hypoxic mixture. Meticulous pre-anaesthetic checks, and use of O2 monitoring at the common gas outlet or in the inspired limb of the breathing system will eliminate this cause. 2 Problems with O2 delivery from lips to lung: The causes of hypoventilation are numerous, but the commonest are central respiratory depression, intrinsic airway obstruction and breathing system obstruction. It is important to note that if patients are breathing high inspired O2 fractions, hypoxaemia

will be a very late (possibly too late) feature of hypoventilation. Figure 2.5 demonstrates how, as alveolar ventilation falls to even very low levels, PAO2 is preserved if the inspired O2 fraction is _30%. This clearly emphasises the fact that pulse oximeters have no place in monitoring the adequacy of ventilation in the critical care setting.