8 Factors that May Lower Oxygen Levels + Tests

Low Oxygen Levels: Signs You May Not Be Getting Enough O2

8 Factors that May Lower Oxygen Levels + Tests

Oxygen is one of the most abundant elements in the universe, which makes it a bit ironic, then, that people with breathing problems are unable to get enough of it.

The body needs to maintain a normal oxygen level, which requires a certain amount of circulating oxygen in the blood at all times to effectively nourish the cells, tissues and organs.

When blood oxygen levels drop below normal, a condition known as hypoxemia may occur.

Hypoxemia is an abnormally low blood oxygen level, which can have many causes and consequences. Hypoxemia can be acute, occurring suddenly because of an emergency situation high altitudes or a blood clot in the artery of a lung.

It can also be chronic, taking place over time because of a long-term health condition COPD or pulmonary fibrosis. Hypoxemia is the main reason that people with COPD and other lung diseases are prescribed supplemental oxygen.

Unfortunately, many people with COPD assume that their symptoms are part of their disease and continue to assume they are maintaining a normal oxygen level. Often, they are unaware that they are hypoxemic and, unless prompted to do so for another reason, they might not immediately seek medical attention.

This can be dangerous because hypoxemia associated with COPD contributes to a reduced quality of life, impaired skeletal muscle function, decreased exercise tolerance and an increased risk of death.1 

If you or a loved one have COPD or another chronic illness that puts you at greater risk for low oxygen levels and hypoxemia, it is important that you are able to recognize the signs and symptoms of lack of oxygen so that appropriate action can be taken if, or when, it occurs. Here are the symptoms of low oxygen levels, as well as how to check your oxygen saturation level at home. 

Symptoms of Low Oxygen in Blood (Hypoxemia)

Low oxygen symptoms of hypoxemia vary depending upon its severity. If you or a loved one experience any of the symptoms listed below, contact a health care provider as soon as possible. If you experience more than one of the following symptoms of low oxygen levels, seek medical attention immediately:

  • Confusion
  • A sense of euphoria
  • Restlessness
  • Headache
  • Shortness of breath
  • Rapid breathing
  • Dizziness, lightheadedness and/or fainting spells
  • Lack of coordination
  • Rapid heart rate
  • Elevated blood pressure
  • Visual disturbances
  • A bluish tint to the lips, earlobes, and/or nail beds (cyanosis)
  • Elevated red blood cell count or polycythemia (if a long-term problem)

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Monitoring Oxygen Levels at Home

The best way to test your oxygen saturation level and detect hypoxemia is through arterial blood gases (ABGs). However, this is generally not possible in the home setting, unless you have a doctor’s order for a home care nurse or respiratory therapist.

Although it should not be used to replace ABG testing in the initial diagnosis of lung disease and the evaluation for long-term oxygen therapy (LTOT), a pulse oximetry monitor plays an important role in the home monitoring of patients with lung disease.

2 Whether patients are using supplemental oxygen or not, a pulse oximetry monitor is an excellent tool for measuring oxygen saturation and helping to maintain a normal oxygen level.

In fact, along with blood pressure, pulse, respiration, and temperature, oxygen saturation is now considered to be the fifth vital sign in many institutions.3

A pulse oximeter is a non-invasive device that measures the oxygen saturation of hemoglobin in the blood.

Because it is able to rapidly detect changes in oxygen saturation, it can provide a warning to patients and health care providers a of impending or existing hypoxemia.

3 For patients using supplemental oxygen, this can help them learn when they need to use supplemental oxygen and when it is most effective for maintaining healthy oxygen levels. 

Normal oxygen saturation levels run between 95% and 100%, but it is typical for patients with lung disease to have a lower than normal oxygen level. Nonetheless, once oxygen saturation levels drop consistently to 88% and below at rest, a patient should be evaluated for supplemental oxygen therapy to help improve overall oxygen levels.4

What to Do if Oxygen Saturation Levels are Low

If you are not already using supplemental oxygen and you are experiencing symptoms of hypoxemia and/or low oxygen saturation levels, do not wait to contact your health care provider immediately.

If you have low oxygen levels, you might want to see about being evaluated for long term oxygen therapy.

Oxygen therapy is appropriate for improving your blood oxygen level and can be effective for many conditions that cause hypoxemia, COPD included.

If you are a current user of supplemental oxygen and you are experiencing symptoms of hypoxemia and/or low oxygen saturation levels, troubleshoot your oxygen equipment to make sure it is working correctly.

It may be advisable to contact your oxygen provider first to ensure that you are checking your equipment correctly, or to get help doing so. If troubleshooting does not resolve your low oxygen levels and you are unable to maintain a normal oxygen level, contact your health care provider.

You may need an adjustment in your oxygen dose or your current course of treatment.

What is a normal oxygen level?

When you measure your blood oxygen level, you will be measuring your oxygen saturation level.

A medical professional will often use an arterial blood gas measurement (ABG for short), while a home oxygen saturation measurement is generally taken with a pulse oximeter (often called pulse ox for short). A doctor may use both.

If you have a normal oxygen level, your ABG oxygen levels will typically fall somewhere between 80 and 100 millimeters of mercury. A normal oxygen level, when measured with a pulse ox, is typically between 95 and 100%.

An ABG measurement below 80 millimeters of mercury, or a pulse ox below 95%, is considered low oxygen saturation. However, if you have a chronic lung disease, your oxygen levels may be different, so talk to your doctor about what a normal oxygen level is for you. 

What happens when oxygen levels are too low?

Your body needs oxygen to work properly, so if your oxygen levels are too low, your body may not work the way it is supposed to. In addition to difficulty breathing, you can experience confusion, dizziness, chest pain, headache, rapid breathing and a racing heart.

If you begin to see blue-tinged nail beds, lips, skin or mucus membranes, that is a sign of cyanosis, which means your blood oxygen levels are dangerously low and could lead to respiratory failure.

If you are experiencing shortness of breath and see blue discoloration, seek medical help immediately. 

How can you improve your oxygen levels?

The first and most important thing to do is to make sure that you are not doing anything to impede your body’s ability to absorb oxygen properly.

That includes quitting smoking if you are still a smoker, avoiding exposure to secondhand smoke and other lung irritants and ensuring you are following treatment orders from your doctor for any condition that may impact your breathing or oxygen saturation.

If you have done all of that and you are still experiencing low oxygen levels, your doctor will ly prescribe supplemental oxygen therapy. Oxygen therapy treatments provide you with a higher percentage of breathable oxygen, improving your oxygen absorption, easing symptoms and raising your oxygen levels.

Oxygen therapy is extremely effective and safe when used as directed. Ask your doctor if oxygen therapy can help you maintain a normal oxygen level, and contact Inogen to find out more about how our oxygen therapy products can help you.  

Deborah Leader RN, BSN, PHN

1Kent, Brian D., Hypoxemia in patients with COPD: cause effects and disease progression. Int J Chron Obstruct Pulmon Dis. 2011; 6: 199–208. March 14, 2011
2Pierson, DJ.

Pulse oximetry versus arterial blood gas specimens in long-term oxygen therapy;168 Suppl:782-8. 1990
3International COPD Coalition. Clinical Use of Pulse Oximetry. Pocket Reference. 2010.

Do I Need Oxygen Therapy for COPD? March 14, 2019

Additional Sources

Healthline. What happens if your oxygen level is too low? January 25, 2017Healthline. Causes of blue hands or feet. May 26, 2017Mayo Clinic. Hypoxemia. September 30, 2005

Source: https://www.inogen.com/blog/signs-your-loved-one-may-not-be-getting-enough-oxygen/

Safe Oxygen Levels: What Should My Oxygen Level Be?

8 Factors that May Lower Oxygen Levels + Tests

If you are using supplemental oxygen, it is important to understand what your oxygen levels should be and when your oxygen levels are not safe. Many people with COPD have oxygen levels that are below normal, even when using supplemental oxygen, so your normal oxygen saturation levels might be different from the norm.

So, what should your oxygen level be and at what point do your oxygen levels go from being below normal to unsafe? Let’s first explore what it means to have low blood oxygen levels.

Low Blood Oxygen Levels = Hypoxemia

Your blood oxygen level is the amount of oxygen circulating in your blood. When blood oxygen levels drop below normal, a condition known as hypoxemia occurs. In COPD, hypoxemia is a problem related to your breathing.

Hypoxemia is determined by measuring the amount of oxygen present in a blood sample taken from an artery, also called an arterial blood gas (ABG) test.

Your oxygen saturation (sometimes called O sats)  can also be estimated using a pulse oximeter, a small device that attaches to your finger and measures the oxygen saturation level in your blood.

Normal arterial oxygen levels as measured by an arterial blood gas range from 75 to 100 millimeters of mercury (mm Hg). According to the Mayo Clinic, values under 60 mm Hg usually indicate that a person needs supplemental oxygen.

Normal oxygen saturation levels as measured by pulse oximetry range from 95% to 100%. Values under 90% are considered low.[1]  

Does that mean you should panic if you have an oxygen level 89? Not necessarily.

And, now with this measurement system, what should your oxygen level be?

First you need to understand which level you are talking about: Your blood oxygen level or your oxygen saturation.

If you have a blood oxygen level between 100 mm Hg and 75 mm Hg, you are doing quite well! So that means that if this is the oxygen level you are speaking about, oxygen level 89, oxygen level 86 and oxygen level 80 would all be just fine.

However, if you were actually talking about your oxygen saturation, a normal oxygen saturation level should fall between 95% and 100%; in this case, a measurement of 89% would be worrisome.  

Blood Oxygen Levels: What’s Unsafe?

Unsafe oxygen levels are determined by your doctor, but in general, you qualify for supplemental oxygen according to Medicare guidelines when your arterial blood gas is at or below 55 mm Hg and/or your pulse oximetry reading is at or below 88% under certain conditions.

This does not mean that a pulse oximetry reading of 90% is safe for you, however. Whenever blood oxygen levels drop for more than a short period of time, your organs and tissues do not get the oxygen they need to function properly.

Over time, this can lead to serious health consequences, such as pulmonary hypertension (high blood pressure in the lungs) and polycythemia (increased amount of red blood cells).[2]  

As such, it is important to be aware of what your normal oxygen saturation and blood oxygen levels are.

Ask your doctor to review a blood oxygen level chart with you so you know what your levels should be and when you should be concerned.

Maintaining Safe Oxygen Levels

When you are given a prescription for supplemental oxygen, your doctor should give you a blood oxygen level chart and a safe range of oxygen saturation levels that they want you to maintain.

You will ly need to have a pulse oximeter on hand so you can measure your oxygen saturation periodically. If you consistently fall below the normal oxygen saturation range your doctor has given you, even with your supplemental oxygen therapy, you should notify your doctor.

It is ly an adjustment may need to be made in your oxygen flow rate or time used.

Your doctor may also give you permission to “titrate” your oxygen flow rate according to your oxygen saturation levels. For example, if your doctor determines that your safe oxygen saturation level should be 92% or above, they may advise you to increase your oxygen flow rate if your saturation drops below 92%.

However, do not adjust your oxygen flow rate or amount of time used without getting express directions from your doctor. Maintaining safe and normal oxygen saturation levels is important for your health and well-being.

If this becomes difficult for you, even while on supplemental oxygen, talk to your doctor as soon as possible.

What should your oxygen level be when sleeping?

Normal oxygen saturation levels drop when we sleep because we breathe more slowly. Additionally, some of our alveoli are not used while we are asleep, which means our lungs are not as efficient.

Typically, doctors prefer that your oxygen level stay at or above 90% while sleeping.

If your normal oxygen saturation is above 94% while you are awake, your oxygen level is unly to fall below 88% while you sleep, but if your doctor is concerned, they may order an overnight pulse oximetry test to be sure. 

What level of oxygen is dangerous?

Only your doctor can determine what is dangerous for you, but there are some basic guidelines. a standard blood oxygen level chart, an ABG measurement of 60 mm Hg or lower indicates the need for supplemental oxygen. A pulse oximeter reading under 90% is considered low and indicates the need for supplemental oxygen as well. 

Is an oxygen level 86 bad if I have COPD?

While people with COPD often have lower oxygen saturation and can safely fall between 92% and 88% when it comes to a normal oxygen saturation for them, it is still essential not to let it fall too low.

An oxygen level below 88% can be dangerous for any period of time. An oxygen level below 85% warrants a trip to the hospital.

Keep in mind that an oxygen level 80% and lower puts your vital organs in danger, so it is important to keep a blood oxygen level chart handy so you know what levels require immediate treatment. 

By Deborah Leader RN, BSN, PHN

[1]  Mayo Clinic. Hypoxemia. December 01, 2018[2] Kent, B. D., Mitchell, P.D, McNicholas, W. T.,  Hypoxemia in patients with COPD: cause, effects, and disease progression. International Journal of Chronic Obstructive Pulmonary Disease, 6, 199-208. March 14, 2011 [3] Katsenos, Stamatis and Constantopoulos, Stavros, H. Long-Term Oxygen Therapy in COPD: Factors Affecting and Ways of Improving Patient Compliance. Pulmonary Medicine. July 18, 2011

Additional Sources

Medical News Today. Low and normal blood oxygen levels: What to know. February 26, 2018

Wikipedia. Oxygen saturation (medicine). September 23, 2019

Verywell Health. Understanding Oxygen Saturation. September 13, 2019

Oxygen Concentrator Store. What is the Normal Oxygen Level? How to Check Your Own Oxygen Level. January 23, 2019

UCSF Health. The Need For Supplemental Oxygen. 

Source: https://www.inogen.com/blog/safe-oxygen-levels/

8 Factors that May Lower Oxygen Levels + Tests

8 Factors that May Lower Oxygen Levels + Tests

Scientists think that low oxygen levels or hypoxia can cause problems with the mitochondria and the brain. Read this post to learn the science behind factors that may lower oxygen levels.

Mitochondria and cAMP

Mitochondria need oxygen.

According to some yet-to-be-verified theories, mitochondrial problems may be at the heart of all chronic diseases. We still have lots to learn about the workings of the mitochondria, though. Plus, complex diseases always involve multiple possible factors – including biochemistry, environment, health status, and genetics – that may vary from one person to another.

We know that when mitochondria are working well, they build up healthy levels of ATP and NAD+ levels, which are important for energy utilization and metabolism. That’s how mitochondria became known as the “powerhouses of cells” [1, 2].

ATP converts to cyclic AMP, which is a critical messenger molecule for so many cellular processes. cAMP is needed for the regulation of glycogen, sugar, and lipid metabolism [3].

Research suggests that the following hormones also require adequate cAMP levels to function optimally: FSH, LH, ADH, TSH, CRH, hCG, ACTH, MSH, PTH, GHRH, Glucagon, and Calcitonin [4].

Read why NAD+ is important.

The body also fights infections with the superoxide that’s created from oxygen [5].

Thus, a person’s health and energy, in part, depend on how much oxygen they have and how well their mitochondria utilize it.

Now there’s obviously more to the story, but you want to make sure the fundamentals are right.

Measuring Oxygen Levels

If you want to measure your oxygen levels, speak to your healthcare provider. They will recommend the best method your health status. Make sure to ask any questions you have about the procedures.

Pulse Oximeters

A pulse oximeter is a small device that clips to a finger. It is described by some as the easiest method to measure blood oxygen.

Doctors will usually use pulse oximetry to assess oxygen levels in people with heart disease, lung disease, anemia, or cancer. It can also be used to monitor health in people taking lung medication, during or after surgery with general anesthesia, to measure physical capacity and breathing, and to check for sleep apnea [6]

People think that oxygen levels can be measured directly with a pulse oximeter. However, these devices measure what percentage of hemoglobin, the protein in blood that carries oxygen, is loaded with oxygen [7].

They know this by measuring the number of red vs infrared that gets absorbed in the tissue. Oxygenated hemoglobin absorbs more infrared light and allows more red light to pass through.

However, this doesn’t measure the number of red blood cells and hemoglobin. Thus, these devices provide an indirect estimate of oxygen levels

They also don’t measure how much blood a person has in a given area, especially the brain.

The normal range of pulse oximeters usually ranges from 95 to 100%. Values under 90% are typically considered low. Some people have suggested that values over 99% are better for optimal function, but there are no data to back this up.

Arterial Blood Gas Test

Hypoxemia is most precisely determined by measuring oxygen levels in arterial blood – called arterial blood gas or ABG.

However, this test is a little more difficult to perform compared to other standard tests, since it requires a blood sample from the artery, which can be more painful and potentially has more complications compared to drawing blood from the veins [8, 9].

Lab results are commonly shown as a set of values known as a “reference range”, which is sometimes referred to as a “normal range”. A reference range includes the upper and lower limits of a lab test a group of otherwise healthy people.

The normal range for arterial oxygen is Normal arterial oxygen is about 75 to 100 millimeters of mercury (mm Hg). Values under 60 mm Hg are usually considered low and may indicate oxygen therapy.

Your healthcare provider will compare your lab test results with reference values to see if any of your results fall outside the range of expected values. By doing so, you and your healthcare provider can gain clues to help identify possible conditions or diseases.

Some lab-to-lab variability occurs due to differences in equipment, techniques, and chemicals used. Don’t panic if your result is slightly range – as long as it’s in the normal range the laboratory that did the testing, your value is normal.

However, it’s important to remember that a normal test doesn’t mean a particular medical condition is absent. Your doctor will interpret your results in conjunction with your medical history and other test results.

Have in mind that a single test isn’t enough to make a diagnosis. Your doctor will interpret this test, taking into account your medical history and other tests. A result that is slightly low/high may not be of medical significance, as this test may vary from day to day and from person to person.

Other Blood Tests

Other blood tests may hint at hypoxia, but they are not used to estimate oxygen levels in the blood. Rather, doctors may order them to find additional clues.

Some examples include:

  • Complete Blood Count
  • Hematocrit
  • Iron levels

Red blood cells carry hemoglobin, which carries oxygen. The more red blood cells a person has, the more they can carry oxygen.

Hemoglobin actually carries the oxygen. The more hemoglobin someone has, the more oxygen they transport.

Hemoglobin comprises about a third of the total red blood cell volume. This protein is responsible for the transport of more than 98% of the oxygen (the remaining oxygen is carried dissolved in the blood plasma).

Hematocrit is a blood test that measures the percentage of the volume of whole blood that is made up of red blood cells. This measurement depends on the number of red blood cells and the size of red blood cells.

Red blood cells and hemoglobin are the most important info in Complete Blood Count readings tied to hypoxia.

Low iron or iron stores may also cause less oxygen utilization because oxygen binds to iron-containing molecules (heme) in hemoglobin. Low RBC and hemoglobin often reflect an iron deficiency.

A low RBC or hemoglobin count may indicate that your erythropoietin (EPO) may be low. Hemoglobin holds oxygen and RBCs hold hemoglobin. EPO helps produce both. Some scientists think that EPO is important for mood and memory independent of its effects on RBCs, but more research on these effects is needed [10].

Blood Pressure

Some people may have good RBCs, hemoglobin, and oxygen saturation, but their issues may arise from poor blood flow, especially to the brain [11, 12].

Blood pressure is one measure of blood flow.

Science suggests that higher blood pressure can indicate that the blood is more viscous, thick, and prone to clogging, which will require more force and pressure to move it.

It can indicate blood vessels that are hardened and unable to relax easily. It can indicate lower nitric oxide. In most cases, the exact cause of high blood pressure is unknown [13].

Low blood pressure means that blood is not flowing with a certain force level, in which case it may not reach the brain. The brain compensates for low blood pressure, but only to an extent [R].

Studies suggest that excessively low blood pressure – such as during prolonged surgeries under general anesthesia – may cause problems with brain circulation. Brain imaging is needed to determine this precisely, though [14].

Blood pressure of 90/60 or under is usually considered low, while normal pressure should be in the range of 110-120/70-80.

Additionally, if you feel you have cold hands or feet, it might be a symptom that blood isn’t going to your peripheral body areas. This may also be an indicator of hypothyroidism (underactive thyroid) and low T3 [15].

In an interview, Dr. Pollack argues that EZ water can improve blood flow. Clinical data are lacking to support his claims, though.

Oxygen Utilization Research

Assuming everything set up to this point is functioning normally in the body, scientists think that it’s still possible not to have enough neuronal NOS and endothelial NOS that will diffuse the oxygen from the circulation into the cells. Their exact impact in humans has yet to be specified, though [16, 17].

In animal studies, UV increases nitric oxide and the relaxation of blood vessels [18].

Scientists are investigating whether UV light can increase free endothelial NOS or eNOS (in vessels/capillaries), total neuronal NOS or nNOS (in neurons) [19, 20], and nitric oxide through other means [18]. In theory, this would allow oxygen to better diffuse into tissues, but more research is needed [21].

nNOS is also important for gut flow and sexual arousal in both men and women. In fact, many natural aphrodisiacs are thought to act by boosting NO [22].

Potential Causes of Hypoxia

Causes shown here are commonly associated with hypoxia/low oxygen levels. Work with your doctor or other health care professional for an accurate diagnosis.

1) Anemia

Your bloodstream must be able to take oxygen from your lungs and carry it to your tissues. People with anemia have low hemoglobin, which means that their oxygen-carrying capacities are reduced.

2) Lung and Nasal Problems or Mucus

To keep your oxygen levels normal, your lungs must be able to inhale enough oxygen and exhale carbon dioxide.

Asthma, COPD, pneumonia, lung scarring, and many other respiratory diseases that affect the lungs are a common cause of hypoxia.

Additionally, people who have nasal blockage may have difficulty breathing, though this is usually much less severe than lung diseases. However, if you have severe problems breathing through your nose (such as a deviated septum) or constant mucus, talk to your doctor to see how your breathing difficulties could be impacting your health and oxygen levels.

3) Obstructive Sleep Apnea

Sleep apnea can lower oxygen levels since it causes people to stop breathing several times during the night. If you think you have sleep apnea, see a qualified doctor to get assessed and diagnosed. Your doctor may recommend that you enroll in a sleep study, which measures oxygen drops while you’re sleeping.

4) High Altitude

Living in an elevated location Colorado or Utah can contribute to hypoxia. People who live in elevated locations often have higher RBCs and hemoglobin to make up for lower blood saturation.

5) Heart Disease

Inborn heart defects in children and adults are a possible cause of low oxygen levels. In this case, the heart is not able to pump blood effectively, so not enough oxygen can reach tissues.

6) Lower Blood Pressure and Poor Circulation

Limited studies suggest that low blood pressure can reduce oxygen levels, and inflammation may be involved. Inflammation and cytokines increase iNOS, which produces large quantities of Nitric Oxide (as opposed to eNOS and nNOS) [22].

Studies point out that iNOS usually occurs with high levels of oxidative stress, and thus high levels of NO have the opportunity to react with superoxide leading to peroxynitrite formation and cell toxicity [22].

Very high levels of uncontrolled nitric oxide through increased iNOS decreases smooth muscle contractions by the heart and lead to lower blood pressure [22].

Nitric oxide from iNOS is thought to be more systemic rather than localized where you need increased blood, which is how eNOS and nNOS are hypothesized to work. Hypoxia locally in the brain may contribute to cognitive problems [23].

7) Psychological Stress

According to some researchers, low oxygen may also be caused by a sympathetic or fight or flight system that is in overdrive. This, in turn, changes breathing. For example, people under stress tend to breathe shallowly. People with anxiety often hyperventilate [24, 25].

It may be a good idea to be more mindful of your breathing. Some people say that 5-6 breaths per minute is a balanced breathing pattern.

Some people who are under stress have normal blood pressure and heart rate (115/75 and 55-70). However, they tend to have low heart rate variability (HRV). HRV is an indicator of vagus nerve function.

8) Chronic Inflammation

Scientists think that there’s complex cross-talk between hypoxia and inflammation. According to them, low oxygen may be caused, in part, by cytokines and other inflammatory messengers, which may prevent oxygen from reaching the tissues from capillaries [26].

Many of the diseases mentioned above-such as heart disease, COPD, asthma, and sleep apnea–involve chronic inflammation. However, further research should pinpoint causes and the exact pathways inflammation and hypoxia use to communicate.

Lack of Sunlight?

The exact impact of sunlight on oxygen levels has yet to be determined. It’s uncertain whether a lack of sunlight can contribute to hypoxia since human data are lacking.

In animals, UV increases nitric oxide and the relaxation of blood vessels [18, 19, 20], which allows oxygen to diffuse into tissues better [21].

More research is needed.

Natural Factors that May Increase Oxygen

These are being researched for increasing EPO in animals:

However, human data are lacking to support their use.

Do not use any device or supplement without consulting your doctor first.

Despite a lack of evidence, people also sometimes use the following devices to increase oxygen:

  • Breathing Exerciser
  • Oxygen Concentrator
  • ICES, which allegedly increases tissue oxygenation

Source: https://selfhacked.com/blog/why-you-may-be-suffering-from-low-oxygen-and-not-realize-it/

Hypoxia vs Hypoxemia: Definition, Symptoms, Signs & Causes

8 Factors that May Lower Oxygen Levels + Tests

Hypoxia is a state of insufficient oxygen supply for normal life functions, and hypoxemia is a state of low arterial oxygen supply.

  • Hypoxia is a condition or state in which the supply of oxygen is insufficient for normal life functions; hypoxemia is a condition or state where there is a low arterial oxygen supply — in some publications these terms are used interchangeably.
  • There are a variety of causes and potential causes of any type of hypoxia.
  • Symptoms of hypoxia and/or hypoxemia may be acute or chronic and vary in intensity from mild to severe. Common acute symptoms are:
    • shortness of breath,
    • rapid breathing, and
    • a fast heart rate.
  • Severe symptoms include:
    • The inability to communicate
    • Confusion
    • Possible coma or death
    • Other associated symptoms also may be present.
  • Hypoxia or hypoxemia symptoms in children may be mouth breathing and drooling.
  • In general, hypoxia and/or hypoxemia is diagnosed by physical examination and by using oxygen monitors (pulse oximeters), determining, oxygen level in a blood gas sample and may include pulmonary function tests.
  • Treatment for hypoxia and/or hypoxemia is to give additional oxygen to the patient and into the environment or the body (blood) as quickly as possible. Techniques vary widely according to the patient's condition, but may include oxygen by face mask or nasal cannula, mechanical ventilation (intubation), hyperbaric chamber, or other devices or medicines to open airways.
  • Hypoxia and/or hypoxemia may be prevented in some individuals by avoiding circumstances that reduce oxygen concentration in the environments or by providing oxygen before symptoms develop. People with asthma can prevent hypoxia/hypoxemia symptoms by taking certain medications on a regular basis as prescribed by their doctor.

What is hypoxia and hypoxemia?

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  • Hypoxia is a condition or state in which the supply of oxygen is insufficient for normal life functions.
  • Hypoxemia is a condition or state in which there is a low arterial oxygen supply.
  • Hypoxia is sometimes used to describe both states (hypoxia and hypoxemia).
  • Within the body, hypoxemia can lead to hypoxia (tissue hypoxia) in various tissues and organs with the most severe being cerebral hypoxia that can rapidly result in brain damage or death.
  • Conversely, if a person experiences environmental hypoxia (low or absent oxygen in the environment from high altitudes or drowning, for example), the person can develop hypoxemia.

Cyanosis is a bluish color of the skin and mucous membranes due to insufficient oxygen in the blood. Symptoms and causes of cyanosis include:

  • The person's lips or fingernail beds may appear blue
  • Certain lung conditions in which lung function is compromised as asthma, COPD, and bronchitis
  • Abnormal forms of hemoglobin or other abnormalities in the blood cells

Read about more symptoms and causes of cyanosis »

What causes hypoxia and hypoxemia?

The causes of both environmental and tissue hypoxia often result in the intermediate state of hypoxemia; thus the causes of any type of hypoxia are also potential causes of hypoxemia. Some of the many causes of hypoxia are the following:

  • Chemical or gas poisoning (for example cyanide, carbon monoxide)
  • Low or absent concentration of oxygen (for example, high altitudes reached without supplemental oxygen as seen in mountain climbing, and aviation, drowning, or fires)
  • Lung problems, for example:
  • Any medications that reduce or stop the effort for breathing (for example, fentanyl and other narcotics)
  • Heart problems (for example, severe bradycardia, and ventricular fibrillation)
  • Anemia and/or conditions that destroy red blood cells
  • Reducing or stopping arterial blood flow to any tissue for organ (for example, arterial blockage by a clot or by injury a gunshot)

Asthma is a chronic respiratory disease. See Answer

What are the symptoms of hypoxia and hypoxemia?

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The symptoms of hypoxia and/or hypoxemia may be acute or chronic.

Acute symptoms can come on rapidly and usually consist of:

  • shortness of breath,
  • rapid breathing, and
  • a fast heart rate.

Other associated symptoms that can occur in both acute and chronic hypoxia and hypoxemia include:

The affected individual may be mildly confused initially and appear weak or may experience rapid changes in the color of his or her skin ranging from blue to cherry red (depending on the causes).

Severe symptoms seen with cerebral hypoxia include:

  • confusion,
  • inability to communicate,
  • coma, and
  • may result in death.

The symptoms in pediatric patients can be similar to the above and may include the following:

  • Lethargy
  • Irritableness
  • Anxiousness
  • Inattentiveness
  • Sitting up and leaning forward to improve diaphragmatic breathing
  • Children with epiglottitis and airway restriction may drool and mainly breathe by mouth.

How is hypoxia and/or hypoxemia diagnosed?

In general, an individual patient’s hypoxemia is usually diagnosed by oxygen monitors placed on fingers or ears (pulse oximeter) and/or by determining the oxygen level in a blood gas sample (a sample of blood taken from an artery). Normal readings are about 94% to 99% oxygen saturation levels; generally, oxygen is supplied if the level is about 92% or below.

Other tests may be ordered to determine if other potential problems such as carbon monoxide poisoning are responsible for the hypoxia.

Pulmonary function tests may also be ordered along with other studies to help determine the cause of unexplained low oxygen saturation.

What is the treatment for hypoxia and/or hypoxemia?

The treatment for hypoxia and/or hypoxemia is to give additional oxygen to the patient and into the body (blood) as quickly as possible, especially if cerebral hypoxia is suspected, or to treat the underlying cause of the hypoxia.

Many patients will respond to additional oxygen supplied by a nasal cannula. The quicker the oxygen level reaches normal, the better the prognosis is for the patient. However, the timing is very important, because cerebral hypoxia can occur within a few minutes and, in many patients, may not be reversible.

Some patients may be treated in a hyperbaric chamber that increases oxygen concentrations in the blood (used in carbon monoxide poisoning), while others may require mechanical ventilation (intubation) with oxygen supplied at higher than normal atmospheric concentrations.

Others, such as mountain climbers or airline passengers, may need only additional oxygen provided by oxygen masks until they reach lower levels where oxygen concentrations are closer to the normal levels (about 21%) in the atmosphere.

However, care must be used when giving oxygen, as it can be toxic to tissues if it is used excessively (hyperoxia). Hyperoxia may cause:

  • vertigo,
  • behavior changes, and
  • other central nervous system changes such as seizures and/or tissue damage that may result in pneumonia, eye changes cataracts, and other organ pathology.

Hyperoxia may occur in patients undergoing hyperbaric therapy or in long-term ICU patients.

Can hypoxia and/or hypoxemia be prevented?

Hypoxia and/or hypoxemia may be prevented in some individuals by avoiding circumstances that reduce the oxygen concentration in the environment or by providing oxygen via nasal cannula or oxygen masks before hypoxia and/or hypoxemia develop.

This can be done by recognizing those individuals who have a tendency to develop hypoxia and/or hypoxemia and provide them with oxygen if they develop any of the early symptoms.

Moreover, there are medications that can provide prevention and/or relief from hypoxia/hypoxemia symptoms that are due to certain medical conditions asthma.

What Is Asthma? Symptoms, Causes, and Treatments See Slideshow

Medically Reviewed on 1/21/2020


Medically reviewed by LaTonya B. Washington, MD; Board Certification in Internal Medicine and Pediatrics REFERENCES: Medscape. Oxygen Therapy in Critical Illness Medscape. Pediatric Respiratory Failure.

Patel, N. D. “Oxygen Toxicity.” JIACM 2003; 4(3): 234-7.

Source: https://www.medicinenet.com/hypoxia_and_hypoxemia/article.htm

Normal blood oxygen levels: What is safe and what is low?

8 Factors that May Lower Oxygen Levels + Tests

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Blood oxygen level is the amount of oxygen circulating in the blood. Most of the oxygen is carried by red blood cells, which collect oxygen from the lungs and deliver it to all parts of the body.

The body closely monitors blood oxygen levels to keep them within a specific range, so that there is enough oxygen for the needs of every cell in the body.

A person’s blood oxygen level is an indicator of how well the body distributes oxygen from the lungs to the cells, and it can be important for people’s health.

The most efficient way to monitor blood oxygen levels is by an arterial blood gas or ABG test. For this test, a blood sample is taken from an artery, usually in the wrist. This procedure is very accurate, but it can be a little painful.

An ABG test can be difficult to do at home, so a person may wish to do an alternative test, using a small device known as a pulse oximeter.

A pulse oximeter is a small clip that is often put on a finger, although it can also be used on the ear or toe. It measures blood oxygen indirectly by light absorption through a person’s pulse.

Although the pulse oximeter test is easier, quicker, and not painful, it is not as accurate as the ABG test. This is because it can be influenced by factors such as dirty fingers, bright lights, nail polish, and poor circulation to the extremities.

For people who wish to purchase a pulse oximeter, there is a range of easy-to-use devices available online.

A normal blood oxygen level varies between 75 and 100 millimeters of mercury (mm Hg).

A blood oxygen level below 60 mm Hg is considered low and may require oxygen supplementation, depending on a doctor’s decision and the individual case.

When blood oxygen level is too low compared to the average level of a healthy person, it can be a sign of a condition known as hypoxemia. This means that the body has difficulty delivering oxygen to all of its cells, tissues, and organs.

Share on PinterestShortness of breath and a rapid heartbeat are potential symptoms of low blood oxygen levels.

Low blood oxygen levels can result in abnormal circulation and cause the following symptoms:

  • shortness of breath
  • headache
  • restlessness
  • dizziness
  • rapid breathing
  • chest pain
  • confusion
  • high blood pressure
  • lack of coordination
  • visual disorders
  • sense of euphoria
  • rapid heartbeat

Hypoxemia, or oxygen levels below the normal values, may be caused by:

  • not enough oxygen in the air
  • inability of the lungs to inhale and send oxygen to all cells and tissues
  • inability of the bloodstream to circulate to the lungs, collect oxygen, and transport it around the body

Several medical conditions and situations can contribute to the above factors, including:

  • asthma
  • heart diseases, including congenital heart disease
  • high altitude
  • anemia
  • chronic obstructive pulmonary disease or COPD
  • interstitial lung disease
  • emphysema
  • acute respiratory distress syndrome or ARDS
  • pneumonia
  • obstruction of an artery in the lung, for instance, due to a blood clot
  • pulmonary fibrosis or scarring and damage to the lungs
  • presence of air or gas in the chest that makes the lungs collapse
  • excess fluid in the lungs
  • sleep apnea where breathing is interrupted during sleep
  • certain medications, including some narcotics and painkillers

People should see a doctor if they:

  • experience severe and sudden shortness of breath
  • experience shortness of breath when at rest
  • have severe shortness of breath that worsens during exercise or physical activity
  • wake suddenly with shortness of breath or a feeling of choking
  • are at high altitude (above 8,000 feet or 2,400 meters) and experience severe shortness of breath with a cough, rapid heartbeat, and fluid retention

Share on PinterestQuitting smoking and avoiding areas where others are smoking may help to improve low blood oxygen levels.

Treatment for low blood oxygen levels includes receiving supplemental oxygen. This can be done at home when it is called home oxygen therapy or HOT.

There is a range of devices for delivering and monitoring HOT, but some of them are considered medications and need a prescription.

Some self-care measures can be taken by people to reduce symptoms of shortness of breath and improve general health and quality of life. These include:

  • quitting smoking
  • avoiding passive smoking in places where others smoke
  • eating a healthful diet with plenty of fruits and vegetables
  • exercising regularly

Low oxygen levels in the blood are not necessarily harmful and can occur in people who can recover, or in healthy people when they are at high altitude. These people do not need to monitor their blood oxygen levels regularly.

But people with chronic lung diseases, such as COPD, pulmonary fibrosis, or emphysema, may have blood oxygen levels below the normal because of their illness. These people may require regular blood oxygen monitoring.

People with low blood oxygen can also make lifestyle changes, such as not smoking or improving their diet and exercise habits, as well as being treated with supplemental oxygen.

Source: https://www.medicalnewstoday.com/articles/321044