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Vocabulary-style flashcards covering key terms and concepts related to hypoxemia, hypoxia, oxygen therapy, and related physiology and clinical considerations.
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Hypoxemia
Decreased oxygen levels in the blood.
Hypoxia
Decreased oxygen delivery to tissues.
FiO2 (Fraction of Inspired Oxygen)
Fraction of inspired oxygen concentration (0.21–1.0).
Goals of Oxygen Therapy
1) Correct hypoxemia/hypoxia (PaO2 <60 mmHg or SpO2 <90%),
2) Decrease symptoms (dyspnea, pulmonary hypertension, cor pulmonale, tachycardia, confusion)
, 3) Decrease cardiopulmonary workload.
Indications for Oxygen (Decision Criteria)
Lab values (PaO2, SaO2),
specific conditions (CO/ cyanide poisoning, trauma, MI, PE, CPR),
bedside signs (tachypnea, tachycardia, cyanosis, confusion).
Hypoxemic Hypoxia
A type of hypoxia due to low arterial oxygen (low PaO2) leading to reduced O2 delivery to tissues.
Circulatory (Stagnant) Hypoxia
Hypoxia from failure of the heart to pump adequate blood; treat by increasing cardiac output.
Anemic Hypoxia
Hypoxia from reduced oxygen carrying capacity (low Hb < ~10 g/dL) or CO poisoning; treat with oxygen and transfusions.
Histotoxic Hypoxia
Tissues cannot use oxygen (e.g., sepsis, cyanide); treat underlying cause.
Normal/Mild/Moderate/Severe Hypoxemia PaO2 Levels
Normal 80–100 mmHg; Mild 60–79; Moderate 40–59; Severe <40.
Age-Related PaO2 Change
After age 60, the lowest acceptable PaO2 tends to decrease ~1 mmHg per year.
Critical Minimum PaO2
PaO2 should be ≥ 55–60 mmHg.
Refractory Hypoxemia
Hypoxemia that does not significantly improve with supplemental oxygen.
Criteria from your slides:
PaO₂ < 60 mmHg despite FiO₂ > 0.50 (50%).
If FiO₂ is increased by 20%, PaO₂ increases by <10 mmHg.
Cause: True shunting (blood bypassing ventilated alveoli).
Treatment: Usually requires hyperinflation therapy like PEEP (Positive End-Expiratory Pressure) or CPAP — not just more O₂
Occult Hypoxemia
SpO2 92–96% but SaO2 <88% on ABG; more common in point-of-care settings.
Early Signs of Hypoxemia
Tachycardia, hypertension, tachypnea, dyspnea, pallor, restlessness, headache.
Late Signs of Hypoxemia
Bradycardia, hypotension, arrhythmias, coma, confusion, cyanosis, impaired judgment.
ABG Normal Values
pH 7.35–7.45; PaCO2 35–45 mmHg; PaO2 80–100 mmHg; HCO3- 22–28 mEq/L.
SpO2 Normal vs Critical Values
Normal 95–97%; Critical 87–90%.
Pulse Oximetry Errors
Common sources: poor perfusion, CO poisoning, nail polish; others include motion, hypothermia, abnormal Hb, light, dyes.
Hazards of Oxygen Therapy
Oxygen-induced hypoventilation,
oxygen toxicity,
retinopathy of prematurity
absorption atelectasis,
fire risk.
Oxygen-Induced Hypoventilation
Risk in chronic CO2 retainers; titrate O2 but avoid withholding O2.
Oxygen Toxicity
PaO2 >150–300 mmHg with free radical injury leading to ALI/fibrosis; limit 100% O2 for <24 hours.
Retinopathy of Prematurity
Neonates exposed to PaO2 >80 torr risk retinopathy.
Absorption Atelectasis
Nitrogen washout with high FiO2 causing alveolar collapse.
Alveolar Gas Equation
PAO2 = (PB − PH2O) × FiO2 − PaCO2/RQ.
A–a Gradient (AaDO2)
AaDO2 = PAO2 − PaO2; normal ~10–20 mmHg on room air.
Oxygen Content (CaO2) Equation
CaO2 = (Hb × 1.34 × SaO2) + (PaO2 × 0.003); normal ≈ 20 mL/dL.
CHAH Mnemonic
Types of hypoxia: Circulatory, Hypoxemic, Anemic, Histotoxic.
HOT RACE Mnemonic
Hazards of O2: Hypoventilation, Oxygen toxicity, Retinopathy, Absorption atelectasis, Combustion, Excess O2.
ABG Norms Mnemonic (7.4/40/90/24)
pH 7.4, PaCO2 40, PaO2 90, HCO3- 24.