anoxia


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Anoxia

 

Definition

Anoxia is a condition characterized by an absence of oxygen supply to an organ or a tissue.

Description

Anoxia results when oxygen is not being delivered to a part of the body. If the condition does not involve total oxygen deprivation, it is often called hypoxia, although the two terms have been used interchangeably. A related condition, anoxemia, occurs when the blood circulates but contains a below normal amount of oxygen.
The five types of anoxia or hypoxia include hypoxemic, anemic, affinity, stagnant, and histotoxic. Hypoxemic anoxia happens when the oxygen pressure outside the body is so low that the hemoglobin, the chemical which carries oxygen in the red blood cells (RBCs), is unable to become fully loaded with the gas. This results in too little oxygen reaching the tissues and can occur in suffocation when a person is at high altitude, where the pressure of oxygen in the air is much less than at sea level.
Anemic anoxia results from a decrease in the amount of hemoglobin or RBCs in the blood, which reduces the ability to get oxygen to the tissues. Anemia may result from lack of production of red blood cells (iron deficiency), blood loss (hemorrhage), or shortened lifespan of red blood cells (autoimmune disease).
Affinity anoxia involves a defect in the chemistry of the blood such that the hemoglobin can no longer pick up as much oxygen from the air, even though the quantities are normal, reducing how much is delivered to the tissues.
Stagnant anoxia occurs when there is interference with the blood flow, although the blood and its oxygen-carrying abilities are normal. A common cause of general stagnant anoxia is heart disease or interference with the return of blood flow through the veins. Examples of local stagnant anoxia include exposure to cold, diseases that restrict circulation to the extremities, and ergot poisoning. When the tissue or organ itself has a reduced ability to accept and use the oxygen, it is called histotoxic anoxia. The classic example is cyanide poisoning, where the chemical inactivates a cellular enzyme necessary for the cell to use oxygen. Thus, tissue exposed to cyanide cannot use the oxygen even though it is in normal amounts in the bloodstream. Histotoxic anoxia can also be caused by exposure to narcotics, alcohol, formaldehyde, acetone, toluene, and certain anesthetic agents.

Causes and symptoms

Anoxia and hypoxia can be caused by any number of disease states of the blood, lungs, heart and circulation including heart attack, severe asthma, or emphysema. It can also result from smoke or carbon monoxide inhalation, improper exposure to anesthesia, poisoning, strangulation, near-drowning, or high altitude exposure through mountain climbing or travel in an insufficiently pressurized airplane. Anoxia, and the resultant brain damage, is a particular problem with newborns during difficult births.
No matter what the cause of anoxia, the symptoms are similar. In severe cases, the patient is often confused and commonly stuperous or comatose (in a state of unconsciousness). Depending on the severity of the injury to the brain, the organ most sensitive to reduced oxygen intake, this condition can persist for hours, days, weeks, or even months or years. Seizures, myoclonic jerks (involuntary muscle spasms or twitches), and neck stiffness are some other symptoms of the anoxic condition.
Symptoms of more localized or less complete oxygen deprivation (hypoxia) include increased breathing rate, lightheadedness, dizziness, tingling or warm sensation, sweating, reduced field of vision, sleepiness, a bluish tint to skin, particularly the fingertips and lips, and behavior changes, often an inappropriate sense of euphoria.

Diagnosis

Diagnosis of anoxia and hypoxia is commonly made through the appearance of clinical symptoms. However, suspected reduction in oxygen reaching the tissues can be confirmed using laboratory tests. The exact test that is performed is dependent on the suspected cause of the anoxia. One systemic measure of tissue anoxia is the serum lactate (lactic acid) test. When cells are forced to produce energy without oxygen, as would happen during anoxia, lactic acid is one of the byproducts. Thus, an increase in lactic acid in the blood would indicate that tissues were starved for oxygen and are using non-oxygen pathways to produce energy. Normally, the blood contains less than 2mmol/L of lactic acid. However, some forms of anoxia do not increase lactic acid concentrations in the blood and some increases in lactic acid levels are not associated with anoxia, so an elevated value for this test is only suggestive of an anoxic or hypoxic condition.

Key terms

Amnesia — Loss of memory often traceable to brain tissue damage.
Anoxemia — An extreme lack of oxygen in the blood.
Hemoglobin — A chemical found in red blood cells that transports oxygen.
Myoclonus — Involuntary contractions of a muscle or group of muscles.

Treatment

The exact treatment for anoxia is dependent on the cause of the reduced oxygen reaching the tissues. However, immediate restoration of tissue oxygen levels through supplementing the patient's air supply with 100% oxygen is a common first step. Secondary steps often include support of the cardiovascular system through drugs or other treatment, treatment of lung disease, transfusions, or administration of anecdotes for poisoning, as appropriate.

Prognosis

A good prognosis is dependent on the ability to treat the underlying cause of the low oxygen levels. If cardiovascular and respiratory systems can be supported adequately, recovery from the injury to the tissue is possible, although extent of injury to the brain can be difficult to assess. The exact amount of recovery varies with the amount of injury sustained, where significant injury brings a poorer prognosis. As recovery occurs, both psychological and neurological abnormalities may appear, persist, and can improve. Some problems seen after anoxia include mental confusion, personality changes, amnesia or other types of memory loss, hallucinations, and persistent myoclonus (involuntary contractions of the muscles).

Prevention

Hypoxemic anoxia can be avoided by utilizing supplemental oxygen when in high altitudes and being aware of the early symptoms of altitude sickness and reducing altitude once recognized. Iron supplements can avoid anemic hypoxia, although more severe anemic states are usually caused by disease or bleeding. Maintaining good cardiovascular health through proper diet and exercise is a good first step to avoiding the most common cause of stagnant anoxia. Avoiding exposure to the toxic chemicals that cause the condition can prevent histotoxic anoxia.

Resources

Periodicals

Gutierrez, Guillermo. "Metabolic Assessement of Tissue Oxygenation" Seminars in Respiratory and Critical Care Medicine 20 (January 1999): 11-15.

Organizations

Brain Injury Association. 105 N. Alfred St. Alexandria, VA 22314. (800) 444-6443. http://www.biausa.org.
Phoenix Project/Head Injury Hotline. Box 84151, Seattle, WA 98124. (206) 621-8558. http://www.headinjury.com.

Other

Borron, Stephen W. "Lactic Acidosis." eMedicine. February 7, 2001. [cited May 13, 2001]. http://www.emedicine.com/emerg/topic291.htm.
NINDS Anoxia/Hypoxia Information Page. The National Institute of Neurological Disorders and Stroke (NINDS). January 22, 2001. [cited May 13, 2001]. http://www.ninds.nih.gov/health_and_medical/disorders/anoxia_doc.htm.

anoxia

 [an-ok´se-ah]
absence of oxygen in the tissues; formerly used interchangeably with hypoxia to mean a reduction of oxygen in body tissues below physiologic levels. adj., adj anox´ic.

an·ox·i·a

(an-ok'sē-ă), Avoid the careless substitution of this word for hypoxia or hypoxemia.
Absence or almost complete absence of oxygen from inspired gases, arterial blood, or tissues.
[G. an- priv. + oxygen]

anoxia

(ăn-ŏk′sē-ə)
n.
1. Absence of oxygen.
2. A pathological deficiency of oxygen, especially hypoxia.

an·ox′ic (-ŏk′sĭk) adj.

anoxia

Hypoxia, see there.

an·ox·i·a

(an-ok'sē-ă)
Absence or almost complete absence of oxygen from inspired gases, arterial blood, or tissues; to be differentiated from hypoxia.
[G. an- priv. + oxygen]

anoxia

Local absence of oxygen, usually as a result of interference with the blood supply. Complete anoxia is rare, the more usual condition being a relative insufficiency, which is known as hypoxia.

anoxia

lack of oxygen in tissues.

anoxia 

Complete absence of oxygen. See hypoxia.

an·ox·i·a

(an-ok'sē-ă) Avoid the careless substitution of this word for hypoxia or hypoxemia.
Absence or almost complete absence of oxygen from inspired gases, arterial blood, or tissues.
[G. an- priv. + oxygen]
References in periodicals archive ?
Although LPS injections and perinatal anoxia are known to be able to cause damage to the white matter and disorganization of M1 (Strata et al.), these two insults may not have affected thoracic limb motor control in the CP group.
2006), are unaffected by anoxia and do not demonstrate lipid peroxidation after hypoxia.
The extensive Siberian volcanism, covering an area of several million km2, profoundly affected the regional and global environments; such as increased SO2 and CO2 in atmosphere and in waters, global warming, ocean acidification, enhance weathering, and ocean anoxia (Ramona et al., 2012).
Treatments that reduce off-target damage from irradiation and preserve the performance of released insects while maintaining adequate levels of sterility, like anoxia conditioning, could have positive impacts on the efficacy and economy of lepidopteran programs with a SIT component.
Las otras ocho causas correspondieron a enfermedades transmisibles, especificamente otras infecciones, que es la causa con mas AVPD en hombres con 1,022; anoxia, asfixia, trauma al nacimiento e infecciones de vias respiratorias bajas con 1,199 AVISA, asimismo se destacan el tumor maligno de estomago; las anomalias congenitas cardiacas y otras enfermedades del aparato digestivo; mientras de accidentes y lesiones se destacan las caidas y ahogamientos (Tabla 1 y 2).
En los mejillones, las condiciones de anoxia pueden ser inducidas por cierre hermetico de sus valvas en presencia de depredadores, enterramientos, anhidrobiosis y sustancias contaminantes (Ladare & Storey, 2002).
Sao citadas como algumas das causas, a anoxia neonatal, prematuridade, hiperbilirrubinemia, baixo peso, hemorragia ventricular e longa permanencia na UTI [24,25].
One study evaluating infants who went through different kinds of stresses, such as intrauterine anoxia, infections, and congenital malformations, demonstrated that these children presented higher birth weight than the expected for the GA as well as a series of alterations in different organs, including the liver [6].
So, such localized anoxia within the upper Barakar estuarine system can be correlated with fluctuations in the atmospheric oxygen level.
However, the avalanche covered the farms' water source, and as a result of anoxia the salmon died," ydris Ecally, the owner of one farm in Hakkari, was quoted as saying.
Florid intracranial calcification in children is caused by birth anoxia, Cockayne disease, tuberous sclerosis, or infections such as toxoplasmosis or cytomegalovirus.