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Anemic Hypoxia

Anemic Hypoxia ->>->>->>

If not enough oxygen gets through at any place on the journey, it can lead to hypoxia. Airflow and blood flow are both important to the process. This is why lung disease and heart disease both increase your risk of hypoxia. Someone who experiences hypoxia is called hypoxic.

Any condition that reduces the amount of oxygen in your blood or restricts blood flow can cause hypoxia. People living with heart or lung diseases such as COPD, emphysema or asthma, are at an increased risk for hypoxia. Some infections, like pneumonia, influenza and COVID-19 can also increase your risk of hypoxia.

Your cells need oxygen to produce energy and help your organs and tissues to do their jobs. While some of your tissues can adjust to temporary dips in oxygen levels, prolonged hypoxia can cause organ damage. Brain and heart damage are particularly dangerous and can lead to death. Lack of oxygen to your brain is called cerebral hypoxia.

Low amounts of oxygen in the blood (hypoxemia) can lead to hypoxemic hypoxia, the most common cause of hypoxia. Hypoxemia can be caused by lung and heart diseases, congenital heart defects, and medications that slow your breathing. Traveling to a high altitude, where levels of oxygen are lower, can also cause hypoxemia.

Your healthcare provider will perform a physical exam, including listening to your heart and lungs. They may check your skin, nails and lips to see if they look bluish. Your provider may also order tests to check your oxygen levels and determine the underlying cause of hypoxia, including:

If you experience symptoms like confusion, rapid heart rate or breathing, or if you notice your nails, lips, or skin appear bluish, you should seek medical attention immediately. Hypoxia should be treated right away to prevent permanent organ damage. COPD and other medical conditions may cause chronic hypoxia with less severe symptoms. Your healthcare provider will talk to you about managing your specific condition to reduce your symptoms and the risk of your oxygen levels dropping too low.

In some circumstances, hypoxia resolves when the underlying condition is treated. In these cases, the need for supplemental oxygen goes away. In other circumstances, you may need chronic supplemental oxygen to ensure there is no ongoing hypoxia or tissue damage from low oxygen levels. Your healthcare provider will discuss your options with you.

Hypoxia can be a life-threatening condition. Go to the emergency room if you have any symptoms of hypoxia or if others notice a sudden change in your behavior or awareness (confusion, restlessness, change in consciousness). Go to the ER if you have an ongoing medical condition and your typical symptoms worsen suddenly, or you experience new symptoms that you think might be hypoxia.

Now that I have my soap box dusted off, I may as well use it. In my opinion, there exists a huge requirement for initial training in high-altitude physiology for all civilian pilots (including general aviation pilots intending to fly above 10,000 feet daytime and 5,000 feet a night). This training is extremely important due to the large number of general aviation pilots who are unaware of the physiological problems that can affect their safety during flight. The training will familiarize pilots with the physiological aspects of high altitude flight, including discussions on physics of the atmosphere, respiration and circulation, hypoxia, hyperventilation, human factors, self-imposed stresses, trapped and evolved gas problems, aircraft decompressions, and oxygen equipment. The training will give pilots an opportunity to experience their personal signs and symptoms of hypoxia in an altitude chamber. Hypoxia is just one of the physiological problems that can impair pilots if they are not aware of the effects of decreased oxygen pressure at altitude.

Hypoxia, by definition, is the lack of sufficient oxygen in the blood, tissues, and/or cells to maintain normal physiological function. Many different factors can cause this state of oxygen deficiency. Breathing air at reduced barometric pressure, malfunctioning oxygen equipment at altitude, drowning, pneumonia, extremes of environmental temperatures, and carbon monoxide are just a few of the causes of oxygen deficiency in the body that results in hypoxia. The most common causes of hypoxia in aviation are: flying, non-pressurized aircraft above 10,000 ft without supplemental oxygen, rapid decompression during flight, pressurization system malfunction, or oxygen system malfunction.

Hypoxia is actually divided into four types: hypoxic hypoxia, hypemic hypoxia, stagnant hypoxia, and histotoxic hypoxia. No matter what the cause or type of hypoxia you experience, the symptoms and effects on your flying skills are basically the same. One factor that makes hypoxia dangerous is its insidious onset; your signs and symptoms may develop so gradually that they are well established before you recognize them. Hypoxia is painless, and the signs and symptoms vary from person to person. To better understand the effects of hypoxia, I will explain each, as well as whether it is the respiratory or circulatory system that is being affected.

This is the most common form of hypoxia encountered in aviation and occurs at the lung level. This type of hypoxia is commonly called altitude hypoxia. Pilots may experience hypoxic hypoxia when flying at altitude in an unpressurized aircraft. With increasing altitude, the molecules of oxygen in ambient air get farther apart and exert less pressure per square inch. The percentage of oxygen does not change as we ascend; however, the partial pressure of oxygen in ambient air decreases as we go to altitude. In other words, with increasing altitude, the partial pressure of oxygen gets lower and the lungs cannot effectively transfer oxygen from the ambient air to the blood to be carried to all tissues in the body.

This type of hypoxia is caused by the reduced ability of the blood to carry oxygen. To the pilot, this means that, even though there is an adequate supply of oxygen to breathe, the blood's capacity to carry the oxygen to the cells has been impaired. There are a variety of reasons for this to happen. Anemia, hemorrhage, hemoglobin abnormalities, sulfa drugs, nitrites, and carbon monoxide interfere with the ability of the blood to carry oxygen, reducing the amount of oxygen the blood can carry to the cells. The most common cause for hypemic hypoxia in aviation is when carbon monoxide is inhaled because of aircraft heater malfunctions, engine manifold leaks, or cockpit contamination with exhaust from other aircraft. Hemoglobin bonds with carbon monoxide 200 times more readily than it bonds with oxygen.

This type of hypoxia occurs at the circulatory level. If the blood flow is compromised for any reason, then sufficient oxygen cannot get to the body tissues. To the pilot, this means, that even though there is an adequate supply of oxygen to breathe, it is not getting to the cells of the body tissues to support their metabolism. Decreased blood flow can result from the heart failing to pump effectively, arterial constriction pooling of the blood such as occurs during neurologic shock or from enlarged veins in the lower extremities. Stagnant hypoxia also occurs when the body is exposed to cold temperatures because the blood flow is decreased to the extremities. This may happen following a rapid decompression during flight or while operating an aircraft in cold weather conditions without cabin heating.

This type of hypoxia happens at the cell level. This means that the cell expecting and needing the oxygen is impaired and cannot use the oxygen to support metabolism. To the pilot, this means that even though there is an adequate supply of oxygen to breathe and that oxygen is being circulated by the blood, the cells are unable to accept or use the oxygen. Alcohol, narcotics, and cyanide are three primary factors that can cause histoxic hypoxia. Cyanide is one of the byproducts during the combustion of plastics.

As I said earlier, no matter what the cause for or type of hypoxia you are experiencing, the signs and symptoms and the effects on your flying skills are basically the same. Hypoxia is easy to succumb to because the human body does not have an effective warning system against the threat. Many incidents and some accidents are "officially" attributed to the pilot's inability to detect hypoxic conditions, with the result that the pilot becomes unsafe because of compromised skills and judgment.

Because hypoxia is insidious and because the signs and symptoms are varied, the safest and most effective way to reduce your risk of becoming hypoxic is to attend a formal course in aviation physiology. Participating in an altitude chamber flight would give you the opportunity to experience hypoxia first hand; you would be able to experience your own symptoms, and would be able to observe the signs of hypoxia in the other class participants. Table 1 shows some of the more common signs and symptoms of hypoxia.

Pilots must understand that the signs and symptoms of hypoxia are as varied and individual as the person experiencing them. Pilots who are hypoxic will experience (most of the time) similar signs and symptoms. However, the signs and symptoms may appear in a different order and in varying intensities.

The greatest benefit in experiencing hypoxia signs and symptoms personally in the hypobaric (altitude) chamber during a high altitude-training course is that you will know what to look for while you are flying. This is important because your signs and symptoms of hypoxia will remain relatively constant throughout your flying career.

These interchangeable terms describe the period of time between the interruption of the oxygen supply or exposure to an oxygen-poor environment and the time when a pilot is unable to perform flying duties effectively, such as putting on oxygen equipment or descending to a safe altitude. Table 2 shows the average TUC or EPT for various altitudes. The table is to be used as a guide only; the times are based on healthy individuals at rest in a hypobaric (altitude) chamber. One important fact to keep in mind is that following a rapid decompression to and above 30,000 feet, the average TUC/EPT will be reduced from 1/3 to 1/2 its original value. This is due to phenomenon known as reverse diffusion or fulminating hypoxia. This occurs when oxygen is forced out from the lungs due to the rapid expansion of gas during a rapid decompression. The result is acute and immediate hypoxia. 59ce067264

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