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Current Affairs

Silent hypoxia

Date: 06 May 2020 Tags: Miscellaneous

Issue

As medical practitioners around the world are busy treating people for Covid-19, many have reported a condition called ‘silent’ or ‘happy’ hypoxia, in which patients have extremely low blood oxygen levels, yet do not show signs of breathlessness.

 

Background

The condition has puzzled medical practitioners, and many are now advocating for its early detection as a means to avoid a fatal illness called Covid pneumonia.

 

Details

  • Hypoxia is a condition wherein there is not enough oxygen available to the blood and body tissues. Hypoxia can either be generalised, affecting the whole body, or local, affecting a region of the body.

  • Normal arterial oxygen is approximately 75 to 100 millimetres of mercury (mm Hg), and normal pulse oximeter readings usually range from 95 to 100 per cent. Values under 90 per cent are considered low.

  • When levels fall below 90 per cent, patients could begin experiencing lethargy, confusion, or mental disruptions because of insufficient quantities of oxygen reaching the brain. Levels below 80 per cent can result in damage to vital organs.

  • Covid pneumonia, a serious medical condition found in severe Covid-19 patients, is preceded by ‘silent hypoxia’, a form of oxygen deprivation that is harder to detect than regular hypoxia.

  • In ‘silent’ or ‘happy’ hypoxia, patients appear to be less in distress. Many Covid-19 patients, despite having oxygen levels below 80 per cent, look fairly at ease and alert, according to multiple reports. This phenomenon has puzzled several medical practitioners.

  • In many cases, Covid-19 patients with silent hypoxia did not exhibit symptoms such as shortness of breath or coughing until their oxygen fell to acutely low levels, at which point there was a risk of acute respiratory distress (ARDS) and organ failure.

  • The reason why people are left feeling breathless is not because of the fall in oxygen levels itself, but due to the rise in carbon dioxide levels that occur at the same time, when lungs are not able to expel this gas efficiently.

  • This happens because in patients with Covid pneumonia, the virus causes air sacs to fall, leading to a reduction in levels of oxygen. However, the lungs initially do not become stiff or heavy with fluid, and remain “compliant”, being able to expel carbon dioxide and avoiding its buildup.

  • A fall in oxygen levels, caused by the silent hypoxia, can serve as a signal for seeking additional treatment immediately, and not wait for a coronavirus test.