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    52 views18 pages

    Hipoksia

    Uploaded by

    dennisaditya

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    of 18

    KLASIFIKASI HIPOKSIA

    Pembimbing:
    dr. Erniody, Sp.An KIC

    Penyusun:
    Berlian Purnamasari Setiono - 406152036

    KEPANITERAAN KLINIK ILMU ANESTESI


    PERIODE 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.
    Hypemic Hypoxia
    An oxygen
    + + deficiency
    +
    +
    due to
    +
    + + reduction in
    +
    + +
    the oxygen
    +
    +
    +
    carrying
    capacity of
    +
    +
    the blood
    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
    CO Poisoning
    • CO is produced by incomplete
    combustion of carbon.
    • CO is a colorless & odourless gas.
    • Hb has 250 times more affinity to
    bind with CO as compared to O2.
    • Carbon monoxide Hb shifts the
    oxy-Hb curve to left  O2
    dissociation becomes difficult.
    • CO also inhibits cytochrome.
    • In CO poisoning, skin is cherry red
    colored.
    • There is no stim. of resp. centre,
    because arterial PO2 is normal.
    • When there is 70% carbon
    monoxy Hb in blood  death
    occurs.
    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

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