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Hypoxemia


Presentation

  • CASE REPORT We present an interesting case of an obese 43-year-old man who presented with progressive, unexplained hypoxemia and shortness of breath in the absence of any symptoms or signs of chronic liver disease.[ncbi.nlm.nih.gov]
Delayed Growth and Development
  • Polycythemia can also occur. [8] In children, chronic hypoxemia may manifest as delayed growth, neurological development and motor development and decreased sleep quality with frequent sleep arousals. [9] Other symptoms of hypoxemia may include cyanosis[en.wikipedia.org]
Recurrent Respiratory Infections
  • We report a case of an infant, with a history of recurrent respiratory infections and wheezing, who presented with persistent hypoxemia (PaO2 88 mmHg) and chronic respiratory symptoms, that prompted an extensive diagnostic work up for chILD; eventually[ncbi.nlm.nih.gov]
Myxedema
Hyperpnea
  • In turn, expiratory flow limitation presents a significant mechanical constraint to exercise hyperpnea, whereas ventilation-perfusion ratio maldistribution and diffusion limitation contribute about equally to the excessive A-a DO(2).[ncbi.nlm.nih.gov]
  • Mechanical constraints on exercise hyperpnea in endurance athletes. J Appl Physiol 73: 874–886, 1992. PubMed Google Scholar 32. McClaran SR, Harms CA, Pegelow DF, and Dempsey JA. Smaller lungs in women affect exercise hyperpnea.[doi.org]
Failure to Thrive
  • An 18-month-old white baby girl with a complex past medical history including choanal atresia, atrioventricular septal defect, failure to thrive, developmental delay, and tracheostomy dependence developed significant hypoxemia and shock following a routine[ncbi.nlm.nih.gov]
Abdominal Pain
  • A 58 year old male with a history of cirrhosis (hepatitis B and C), a long smoking history, and a recently diagnosed high-grade transitional cell carcinoma of the bladder wall presented three days after a biopsy procedure with abdominal pain, nausea,[ncbi.nlm.nih.gov]
Impulsivity
  • Hypoxia occurs when the breathing center doesn't function correctly or when the signal is not appropriate: Strokes, epilepsy and cervical neck fractures can all damage the medullary respiratory centres that generates rhythmic impulses and transmit them[en.wikipedia.org]

Workup

  • After a detailed but unsuccessful workup, a contrast CT scan revealed an occluded superior vena cava and azygos vein-superior vena cava junction and massive right-to-left shunting through a network of systemic to pulmonary venous collaterals.[ncbi.nlm.nih.gov]
  • Diameters of Pulmonary Capillaries and Substances Used in the Diagnostic Workup of the Hepatopulmonary Syndrome Other examinations sometimes performed in patients with suspected hepatopulmonary syndrome are transesophageal echocardiography when cardiac[rc.rcjournal.com]

Treatment

  • MEASUREMENTS AND MAIN RESULTS: Data for blood gas analysis, vital signs, heart function, and complications were collected before the treatment, after 1 and 6 hours of treatment, and at the end of treatment.[ncbi.nlm.nih.gov]

Prognosis

  • […] different types of chronic hepatic diseases with associated portal venous hypertension, resulting in pulmonary vascular dilatation, predominantly in the lower lung fields, and leading to ventilation-perfusion mismatch, arterial hypoxemia and a poor prognosis[ncbi.nlm.nih.gov]
  • The prevalence of this population in ICU is unknown, likewise its prognosis. In this way, it would be interesting to compare, for each levels of hypoxemia (mild, moderate and severe) the prognosis of the patients with and without ARDS.[clinicaltrials.gov]
  • […] rate of 16-30% at 1 year from the time of diagnosis. 12 Hepatopulmonary syndrome should be intentionally looked for in children with liver disease who present with dyspnea and hypoxemia and who are in a liver transplantation protocol because prognosis[elsevier.es]

Etiology

  • PRINCIPAL FINDINGS: The use of TELU can provide point-of-care real-time information for quickly establishing the etiology of acute hypoxemia.[ncbi.nlm.nih.gov]
  • Definition Etiology Causes of Hypoxia Inadequate Oxygen Delivery : inadequate minute ventilation or FiO2; mechanical failure, disconnect R-L Shunt : intracardiac shunting V/Q Mismatch : mainstem, pulmonary edema, aspiration, atelectasis, pulmonary embolus[openanesthesia.org]
  • In this article, the author reviews the etiology and consequences of IH in preterm infants.[neoreviews.aappublications.org]
  • Pulmonary capillary vascular dilatation 4,5 Development of hepatopulmonary disease is independent of the etiology of the liver disease.[elsevier.es]
  • However, determining the etiology of the shunt proved complicated. Pulmonary Arteriovenous Malformations and Hereditary Hemorrhagic Telangiectasia Intrapulmonary shunting is typically caused by the presence of PAVMs.[atsjournals.org]

Epidemiology

  • University of Pennsylvania, Philadelphia, PA. 7 Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA; Center for Clinical Epidemiology[ncbi.nlm.nih.gov]
  • It appears then important to provide epidemiological data regarding these gaps of knowledge that could help to design future trials on acute respiratory failure.[annalsofintensivecare.springeropen.com]
  • Original Articles Epidemiology and Outcomes Open Access, Hanjie Zhang, Xiaoling Ye, Doris H.[cjasn.asnjournals.org]
  • All Events ERS Course Early Bird deadline 31 August, 2019 Paediatric respiratory infections Lisbon, Portugal 13-15 November, 2019 This course will present state-of-the-art advances and best practices in the epidemiology, diagnosis, management and prevention[ersnet.org]
Sex distribution
Age distribution

Pathophysiology

  • In addition to intrinsic cardiopulmonary diseases and hepatopulmonary syndrome, some unusual pathophysiological mechanisms in patients with portosystemic collaterals might contribute to hypoxemia.[ncbi.nlm.nih.gov]
  • Echocardiography suggested that intrapulmonary shunt was the most likely underlying chronic pathophysiology. Table 1.[atsjournals.org]
  • Pathophysiology and treatment of high-altitude pulmonary vascular disease. Circulation. 2015;131:582. Living with COPD. National Heart, Lung, and Blood Institute. . Accessed Nov. 18, 2015. .[mayoclinic.org]

Prevention

  • OBJECTIVE: To compare the efficacy of two oxygen devices (nasal cannula and mask) and two flows for preventing hypoxemia in post anesthesia care unit (PACU).[ncbi.nlm.nih.gov]
  • Continued Preventing Hypoxia The best way to prevent hypoxia is to keep your asthma under control, every day. Stick with your asthma treatment plan. Take your medicine to help prevent flares and the need to use your rescue inhaler.[webmd.com]

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